ENGLISH - SPESWEB_2019_Februari

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     Shortness of breath


What is Pectus excavatum ?
As  its name suggests, it presents with an excavated, sunken or  funnel chest.
Pectus excavatum is a depression of the anterior chest wall of variable severity  that may be mild, moderate, or severe.
Why this website ?  The main purpose of this website is to convey the message,  to both patients and doctors,  that pectus excavatum (funnel chest) can cause serious health problems.
This website focusses on Symptomatic Pectus Excavatum in seniors (SPES)
Tiredness, loss of stamina;
Shortness of breath, slowly increasing and worsening;
Ectopic heartbeats experienced as "palpitations", sometimes even tachycardia;
The complaints are influenced by the body posture of the patient.
(see pictures in screen "Houding en klachten)
Influence of body posture on the symptoms:
  •  complaints increase when the patient bows  or bends his head
      (diminished thoracic volume)
  •  complaints diminish when the patient is walking upright with raised head
      (increased thoracic volume).    
  •  lifting up the ribcage  while walking will immediately provide more "air" to the patient.

  • anamnesis: listen carefully to the complaints of the patient;
  • inspection and palpitation: verify the existence of a funnel chest;
  • auscultation: listen to the heartsounds;
  • body posture has influence on the complaints;
  • there is no other reasonable explanation for the complaints.
  • Additional examinations by a cardiologist for confirmation and exclusion of any other type of heart-disease:       
     X-Thorax;  HR-CT thorax;   ECG  and  ECHO of the heart

"You’ll only see it if you know it" (Johan Cruyff)
Most physicians are not aware of the connection between a funnel chest and the above mentioned complaints. They even fail to recognise that their patient has a pectus excavatum. Medical students are taught that a funnel chest has to be considered as a cosmetic problem and that it can only cause medical problems in exceptional cases. Therefore most physicians are not prepared to believe that this congenital deformation of the thoracic cage will lead to medical problems at advanced age (50+)

The structure of the vertebral columnn changes as age advances, the intervertebral space decreases and the vertebral column starts bending forward. The breastbone protrudes as a kind of wedge inward and will gradually start exerting  pressure on the right side of the heart. This cardiocompression will cause the medical complaints mentioned. Body posture can relieve or increase the complaints.
In spite of all evidence provided by articles in respected and peer-reviewed medical journals some doctors still deny that the above mentioned medical problems could be caused by a funnel chest. In doing so, they also deny their patient a possible treatment. Most patients experience a considerable improvement of their quality of life after surgical correction of the funnel chest. (Ravith operation)
Links to Medical Literature, websites and pictures

For further information regarding complaints, diagnosis and  surgical treatment
please follow these links to websites en literature

If you have any comments on this website or if you should have new information about the course of the disease in patients with SPES,
please do not hesitate and send your email to the author.

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