Pectus excavatum (PE) patients may present with symptoms including dyspnea and chest pain with exertion, inability to keep up with peers and exercise intolerance. Medical documentation of a cardiopulmonary limitation is often needed as severity of the pectus deformity does not necessarily correlate with symptoms. The cardiopulmonary test (CPET) is an assessment tool that allows for examination of the patient's cardiovascular and ventilatory responses to maximal exercise and can be used to assess PE physiologic limitations.
A prospective study of 10 PE patients was performed utilizing the CPET as an analytical tool to assess cardiopulmonary limitations with correlation to symptoms.
10 pectus patients underwent CPET analysis. Nine of the 10 patients had symptomatic complaints related to their pectus deformity. Six were men and the mean age was 34 years (range 14–78). Eight of the 10 patients had evidence of a cardiovascular limitation based on peak VO2, anaerobic threshold and O2 pulse (Figures 1, 2). There were no ventilatory limitations to exercise. Extrinsic right ventricular compression was seen by echocardiogram or computerized tomography in four of the patients. Symptom correlation was seen with cardiovascular limitations found on CPET in all but one patient. Figure 1:Figure 2:Mean VO2/CO2 Slope in Pectus PatientsMean VO2/Heart rate Slope.
Cardiovascular limitation from severe PE can be documented with CPET analysis. This is a noninvasive method to help clinicians assess patients presenting with symptoms and PE.
Medical documentation of a cardiopulmonary limitation is often needed as severity of the pectus deformity does not necessarily correlate with symptoms.
Dawn Jaroszewski, No Financial Disclosure Information; No Product/Research Disclosure Information