• H A Kragten, J Siebenga, P F Höppener, R Verburg, and N Visker.
• Department of Cardiology, Atrium Medical Centre Parkstad Heerlen, Henri Dunantstreet 5, 6419PC, Heerlen, the Netherlands.
• Neth Heart J. 2011 Feb 1; 19 (2): 73-8.

ObjectivesThere is no consensus among physicians as to whether or not pectus excavatum can produce symptoms sometimes even severe enough to justify a surgical procedure. The aim of this study was to assess the prevalence and severity of complaints and symptoms of senior patients with a pectus excavatum and to evaluate the results of surgical correction of the chest deformation.DesignThis is a prospective clinical study, case series.ParticipantsThe participants are 42 senior patients with a pectus excavatum and somatic complaints.MethodsCardiological screening included medical history taking, physical examination, electrocardiography, transthoracic echocardiography and treadmill cardiography. Complaints, symptoms and test results were arranged in a clinical score. Indication for a therapeutic surgical correction by a modified Ravitch operation was a high clinical score in combination with radiological evidence of cardiac compression on CT or MRI.ResultsThe clinical picture of the 42 senior patients with a pectus excavatum showed complaints of fatigue and low exercise tolerance, shortness of breath, palpitations, inspiratory obstruction and sometimes chest discomfort or pain. The serious and sometimes invalidating complaints of 19 patients (45%) had started only in their fourth or fifth decade of life and were labelled in 12 patients (63%) as 'Unexplained cardiovascular complaints'. To date, 11 patients have undergone surgical procedures. Symptoms were reduced substantially or had disappeared completely. All patients indicated that their health-related quality of life was significantly improved.ConclusionRecognising the clinical picture of SPES is relevant because surgical reconstruction of the chest can provide substantial relief of symptoms.

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