Thursday, July 3, 2014

Spelunker


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.

2 comments:

city said...

severe pectus excavatus with SVC compression?

Craig Chen said...

well done!
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Spelunker

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.