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Family Medicine (Expert Forum)
Pectus causing back pain?
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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Pectus causing back pain?
by Kroms_laugh, Sep 02, 2005 12:00AM
I went to the ER with chest pain and was told that a chest wall deformity (they called it pectus excavatum) I've had nearly all my life is the source of my back/chest pain. The chest pain is not nearly as bad as it was, I just feel a little tight in the chest every now and then, but the back pain has persisted.
A thoracic spine MRI was done and nothing abnormal could be found. All okay there. An EKG came back normal and an x-ray revealed a healthy heart size and position in my chest cavity.
What worries me now is whether or not I will qualify for the corrective surgery for pectus excavatum (minimally invasive Nuss procedure) because it's not causing pulmonary distress or shortness of breath. I know the next step is to get a CT for my heart and lungs,
but
If my back is healthy now, as the MRI reported, could the pectus cause it to get worse over time? I am *seriously* concerned about my back because I am in school to be a firefighter and my back is the single most important asset to my career. My back has a 'hump' (from the pectus, is what I'm told) only on the right side about halfway down my back. As shown here;
http://img152.imageshack.us/img152/7893/pectus11edit9ql.jpg
NOTE: I should add that my pectus is only on the right side of my chest and it's not very severe at all. Picture;
http://img237.imageshack.us/img237/4821/pectus14edit7wi.jpg
A thoracic spine MRI was done and nothing abnormal could be found. All okay there. An EKG came back normal and an x-ray revealed a healthy heart size and position in my chest cavity.
What worries me now is whether or not I will qualify for the corrective surgery for pectus excavatum (minimally invasive Nuss procedure) because it's not causing pulmonary distress or shortness of breath. I know the next step is to get a CT for my heart and lungs,
but
If my back is healthy now, as the MRI reported, could the pectus cause it to get worse over time? I am *seriously* concerned about my back because I am in school to be a firefighter and my back is the single most important asset to my career. My back has a 'hump' (from the pectus, is what I'm told) only on the right side about halfway down my back. As shown here;
http://img152.imageshack.us/img152/7893/pectus11edit9ql.jpg
NOTE: I should add that my pectus is only on the right side of my chest and it's not very severe at all. Picture;
http://img237.imageshack.us/img237/4821/pectus14edit7wi.jpg
Doctor's Answer
by Kevin Pho, MD, Sep 05, 2005 12:00AM
, Sep 05, 2005 12:00AM
Treatment for pectus excavatum is controversial since there are no consensus studies showing clear benefit. Some reports show improvement in lung function, exercise tolerance, and stroke volume postoperatively - while others suggest that that surgery should be reserved for cosmetic purposes.
One suggested criterion is a transthoracic lateral diameter to sternovertebral distance ratio of greater than 3.5, however this can be discussed with your surgeon.
Because there is controversy about the approach to treatment, a second opinion may not be a bad idea in this instance.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
One suggested criterion is a transthoracic lateral diameter to sternovertebral distance ratio of greater than 3.5, however this can be discussed with your surgeon.
Because there is controversy about the approach to treatment, a second opinion may not be a bad idea in this instance.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
http://www.straightfromthedoc.com
Member Comments (1)
by Kroms_laugh, Sep 02, 2005 12:00AM
And if I don't qualify for the Nuss procedure to fix the excavatum... what other options are there for me?
