| Pectus
excavatum (PE) is a relatively common congenital deformity of the
anterior chest wall associated with reduced exercise capacity. Uncertainty
exists over the nature of physiologic impairment in PE. Evidence suggests
that myocardial compression exerted by the displaced sternum on the
right heart chambers, disables the ability of the heart to augment
stroke volume during exercise. This case study describes the evaluation
of an athletic 20 year old Caucasian male, lifelong non-smoker, with
severe pectus deformity and previous fixation procedure to repair
a sternal fracture. The patient performed an incremental cycle ergometer
exercise test to determine the etiology of his dyspnea with exertion.
The patient demonstrated normal work output and normal aerobic capacity
but displayed dynamic hyperinflation. Mechanical restriction of tidal
volume expansion appeared to be the major contributors to exercise
limitation. These results are compared and contrasted with similar
cases reported in the literature.
KEY
WORDS: Funnel chest, exercise test, ventilatory limitation.
|
