Document Detail

Pectus excavatum with inspiratory inferior vena cava compression: a new presentation of pulsus paradoxus.
MedLine Citation:
PMID:  15654179     Owner:  NLM     Status:  MEDLINE    
A 29-year-old man with pectus excavatum presented with exercise intolerance, pulsus paradoxus, and paradoxically split S2. Chest computed tomography (CT) showed the heart shifted leftward and a pectus severity index of 7.18. Cardiopulmonary exercise study showed reduced VO2max, anaerobic threshold, and oxygen pulse. Echocardiography revealed a decline in mitral and tricuspid valve inflow, and stroke volume during inspiration. Cardiac extrinsic compression and anatomic cardiac abnormalities were not present. Dynamic magnetic resonance imaging (MRI) demonstrated inspiratory inferior vena cava (IVC) compression at the diaphragm. We discuss IVC compression by the diaphragm as a source of patient symptoms and as a mechanism for pulsus paradoxus associated with pectus excavatum.
Kishore Yalamanchili; Warren Summer; Vincent Valentine
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  329     ISSN:  0002-9629     ISO Abbreviation:  Am. J. Med. Sci.     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2005-01-17     Completed Date:  2005-02-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  45-7     Citation Subset:  AIM; IM    
Division of Pulmonary and Critical Care, Louisiana State University Health Science Center, New Orleans, Louisiana 70112, USA.
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MeSH Terms
Dyspnea / physiopathology
Exercise Tolerance*
Funnel Chest / pathology,  physiopathology*
Heart / physiopathology
Magnetic Resonance Imaging
Vena Cava, Inferior / pathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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