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

被引：9
作者：
Yalamanchili, K
Summer, W
Valentine, V
机构：
[1] Louisiana State Univ, Hlth Sci Ctr, Div Pulm & Crit Care, New Orleans, LA 70112 USA
[2] Louisiana State Univ, Hlth Sci Ctr, Ochsner Clin Fdn, New Orleans, LA 70112 USA
来源：
AMERICAN JOURNAL OF THE MEDICAL SCIENCES | 2005年 / 329卷 / 01期
关键词：
pectus excavatum; pulsus paradoxus; inferior vena cava; stroke volume; inspiration;
D O I：
10.1097/00000441-200501000-00008
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
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 VO(2)max, 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.
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收藏
页码：45 / 47
页数：3
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