Pectus Excavatum and Cardiac Disease

This presentation is a case report on a patient treated with repair of a pectus excavatum with total resolution of the symptoms. The patient presented with long-standing cardiac arrhythmias for which an ablation was recommended by the cardiologist. The patient performed an Internet search on the relationship of an excavatum and cardiac effects and presented with a request for repair of the excavatum. A modified Ravitch was performed. The patient gradually decreased his antiarrhythmic drugs with the arrhythmia totally disappearing. When seen 3 years later the symptoms had totally resolved.

Cardiac effects and pectus excavatum is poorly recognized. There is however increasing evidence of the association and the importance of the repair. I will discuss the hypothesis that compression of the right ventricle causes decreased return of blood with exercise and resultant effort intolerance as well as arrhythmias usually late in life. I will review the literature. Pectus is underrecognized as a cause of cardiopulmonary symptoms and requires early repair preferably with a Nuss procedure.