Cardiac Findings in Pectus Excavatum in Children: Review and Differential Diagnosis

¹ Mayo Clinic and Mayo Foundation, Rochester, Minnesota

The majority of 54 children with pectus excavatum and normal hearts presented findings suggestive of cardiac disease on auscultation, electrocardiography, vectorcardiography, and chest roentgenographic examination. Although auscultatory findings were similar to those encountered in cases of mild pulmonary stenosis and small atrial septal defects, and although the scalar electrocardiographic and the radiologic features resembled those of mild right ventricular pressure or volume overload, these signs were not specific enough to suggest the presence of a cardiac malformation. Because the findings could be explained by the position of the heart, cardiac catheterization was not carried out in any patient. Among the clinical examinations, changes due to displacement of the heart were least evident in the Frank vectorcardiogram, which may prove useful in the clinical exclusion of congenital heart disease in cases of pectus excavatum.

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