Thursday, July 3, 2014


Challenge: These images from a 12 year old boy with exercise intolerance, chest pain, poor endurance, and shortness of breath show what?

Image shown under Fair Use.


city said...

severe pectus excavatus with SVC compression?

Craig Chen said...

well done!

This is pectus excavatum, a sternal depression beginning over the midportion of the manubrium and progressing inwardly through the xiphoid process. Panel A shows horizontally oriented posterior ribs (arrow), an ill defined right heart border (arrowhead), and vertically-oriented anterior ribs (dashed arrow). Panel B shows a posterior positioned sternum. Panel C shows a depressed sternum, compressed right atrium (arrowhead), and leftward displacement of the heart. Panel D also shows posterior displacement of the sternum and compression of the right atrium.

Source: UpToDate.