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Pectus Excavatum

Frequently Asked Questions

 

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Question: What can you tell me about surgery for pectus excavatum?

Answer: One point to note is that if I had to do my pectus excavatum surgery over again, I would only go to a surgeon who specialized in pectus excavatum repair. I had my operation when I was 17 and didn't know how to evaluate and compare surgeons, so I just went to a a thoracic surgeon referred to me by my family doctor. The surgeon I went to did not specialize in PE repair, and I realize now he probably had not done very many, if any, of these types of surgeries and was not aware of the latest techniques.

I suspect my surgery results would have turned out better if I had gone to someone with more expertise in just pectus excavatum repair. If I ever have a pectus excavatum redo, I would only go to someone who specialized in sunken chest surgery, was up on the latest surgical techniques and was recommended by other people who had pectus excavatum repairs done by him/her. One person who wrote to me asked a prospective surgeon for some before and after pictures of his work. This sounded like a good idea.

I'd also have nutritional testing and a bone density test *before* my surgery to make sure I didn't have soft bones that were just going to sink in again right after the surgery.

A prudent question is one-half wisdom.
Francis Bacon

To share experiences with others who have PE and to trade information about PE surgery and surgeons, check out the Pectus Message Boards.

Question: I have PE and I get weird pains and palpitations in my chest and heart. My doctor has run some tests and says I'm perfectly healthy, but I don't feel healthy. I feel like something is really wrong with me. My doctor thinks my problems are all in my head.

Answer: Heart conditions, especially mitral valve prolapse, are not uncommon problems for people with pectus excavatum. Anxiety conditions are also common. In my case, and probably many others with pectus excavatum and/or MVP syndrome, it wasn't that my problems were all in my head, it's that I had some nutritional imbalances that were impacting both my physical and emotional health.

I've gotten several emails exactly like the one above, often from guys in their 20s with pectus excavatum who have chest pains and palpitations and their doctors just brush them off and say they seem healthy.

It's my understanding that the only way to tell if you actually have mitral valve prolapse or a more serious problem along those lines is by having an echocardiogram. The only types of doctors I've known who were aware of the link between pectus excavatum and mitral valve prolapse were geneticists. The only times I ever had echocardiograms ordered for me were for genetic evaluations, so having a genetic exam may be something to consider if you have PE and are experiencing heart problems, too.

There are many studies on PubMed noting a link between pectus excavatum, mitral valve prolapse and other heart problems. It is unfortunate that more doctors are not aware of the connection between PE and heart conditions. If they did, they would know pectus excavatum is a known risk factor for heart problems, and they could watch out for these types of problems in their patients before they become too serious.

What some people have done who have read my site has been to print out some of the studies on Medline about the links between PE and mitral valve prolapse and related heart problems. They've taken the abstracts for these studies to their doctors for them to review. I think printing out relevant studies and taking them to your doctors is good advice for many conditions. When I've told my non-nutrition oriented doctors about something I read on the Internet, they just roll their eyes and look at me like I'm a moron. However, when I've printed out the actual studies or abstracts that I found on the Internet that first appeared in respected medical journals, I've found they actually pay attention to that type of information, especially if it is highly relevant to my symptoms.

Here are some excerpts of papers which show there is a link between pectus excavatum and cardiac problems:

Thoracic skeletal abnormalities in young men with mitral valve prolapse. "Mitral valve prolapse should be excluded in patients with thoracic skeletal abnormalities, especially those presenting with cardiac murmurs."

[Phono- and echocardiographic studies of the genesis of mitral valve prolapse in patients with funnel chest.] "In 44 patients with funnel chest, 20 (45%) had MVP (mitral valve prolapse) and 15 (34%) had MR (mitral regurgitation) , respectively."

Pulmonary function studies in patients with prolapse of the mitral valve. " We studied the pulmonary function and chest x-ray films of 20 nonsmokers with idiopathic prolapse of the mitral valve. Forty-five percent of these patients complained of dyspnea. Of the 16 chest films reviewed, 44 percent had radiographic evidence of pectus excavatum and 25 percent thoracic scoliosis."

Thoracic skeletal abnormalities in idiopathic mitral valve prolapse. " Idiopathic prolapse of the mitral valve is a common disorder, but many cases are clinically subtle. Thoracic skeletal abnormalities, reported recently to accompany the syndrome, may serve as an easily identifiable clinical indicator.........Patients with "straight back" and pectus excavatum should be examined clinically and perhaps by echocardiography to exclude idiopathic prolapse of the mitral valve; when murmurs are present, a diagnosis of "pseudoheart disease" should not be made before mitral valve prolapse has been excluded."

Chest wall deformities. "Scoliosis (13.5%), Poland's syndrome (5.4%), Marfan's syndrome (5.4%), neurofibromatosis (2.7%), atrial septal defect (2.7%) and mitral valve prolapse (13.5%) were associated with pectus deformities."

Incidence and risk factors for mitral valve prolapse in severe adolescent idiopathic scoliosis. "Mitral valve prolapse (MVP) is known to be associated with thoracic skeletal anomalies."

This is a sample of some of the studies showing a link between PE and cardiac problems. There's more studies on PubMed, and you can find them by entering:

pectus excavatum mitral valve prolapse

in the search field on the "Entrez PubMed" web page.

Question: Should everyone with pectus excavatum have an echocardiogram?

Answer: Sorry, but I can't really give anyone advice along those lines. My understanding is that it is not common medical practice now to check people with pectus excavatum for mitral valve prolapse or related heart problems, however, based on the high volume of studies linking pectus excavatum to heart problems, logically it seems like something that should be investigated and considered.

My doctor orders an echocardiogram for me every year because I have PE is in conjunction with Ehlers-Danlos syndrome, which is linked to heart problems.

If you have features of Marfan syndrome or a relative with Marfan syndrome, then I believe conventional medical advice is to have a genetic exam, which would most likely include an echocardiogram. A number of people have died from heart complications from Marfan syndrome, so it's not something to take lightly.

For more information, see my main page on What Causes Pectus Excavatum? and my PE Exercises page.

 

 

 

 

Related sections of interest:

Links to Diet in Connective Tissue Disorders.

Genes may not be the only cause of Marfan Syndrome

Osteogenesis Imperfecta

Diet Help for EDS (Ehlers-Danlos Syndrome)

Pectus Excavatum Causes, FAQ, and Exercises

Could Hyaluronic Acid Help with Aging or Connective Tissue Disorders?

Wrinkled and Dry Skin - What you Eat May Make a Difference

Zinc Deficiency Symptoms

 

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