Pectus excavatum with inspiratory inferior vena cava compression: A new presentation of Pulsus paradoxus

Kishore Yalamanchili; Warren Summer; Vincent Valentine

doi:10.1097/00000441-200501000-00008

Pectus excavatum with inspiratory inferior vena cava compression: A new presentation of Pulsus paradoxus

Kishore Yalamanchili, Warren Summer, Vincent Valentine

Research output: Contribution to journal › Article › peer-review

13 Scopus citations

Abstract

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.

Original language	English (US)
Pages (from-to)	45-47
Number of pages	3
Journal	American Journal of the Medical Sciences
Volume	329
Issue number	1
DOIs	https://doi.org/10.1097/00000441-200501000-00008
State	Published - Jan 2005
Externally published	Yes

Keywords

Inferior vena cava
Inspiration
Pectus excavatum
Pulsus paradoxus
Stroke volume

ASJC Scopus subject areas

General Medicine

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10.1097/00000441-200501000-00008

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title = "Pectus excavatum with inspiratory inferior vena cava compression: A new presentation of Pulsus paradoxus",

abstract = "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.",

keywords = "Inferior vena cava, Inspiration, Pectus excavatum, Pulsus paradoxus, Stroke volume",

author = "Kishore Yalamanchili and Warren Summer and Vincent Valentine",

year = "2005",

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doi = "10.1097/00000441-200501000-00008",

language = "English (US)",

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pages = "45--47",

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T1 - Pectus excavatum with inspiratory inferior vena cava compression

T2 - A new presentation of Pulsus paradoxus

AU - Yalamanchili, Kishore

AU - Summer, Warren

AU - Valentine, Vincent

PY - 2005/1

Y1 - 2005/1

N2 - 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.

AB - 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.

KW - Inferior vena cava

KW - Inspiration

KW - Pectus excavatum

KW - Pulsus paradoxus

KW - Stroke volume

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Pectus excavatum with inspiratory inferior vena cava compression: A new presentation of Pulsus paradoxus

Abstract

Keywords

ASJC Scopus subject areas

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