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Pectus excavatum in children: diagnostic significance for mitral valve prolapse
1Department of Pediatrics, Texas Tech University Health Sciences Center, Lubbock 79430.
Insights
Children with pectus excavatum have a high incidence of mitral valve prolapse (MVP), particularly those over 8 years old or with severe chest deformities. Early cardiac screening is recommended for these pediatric patients.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Imaging
- Congenital Heart Abnormalities
Background:
- Pectus excavatum is a common chest wall deformity in children.
- Mitral valve prolapse (MVP) is a potential cardiac complication.
- The association between pectus excavatum and MVP in pediatric populations requires further investigation.
Purpose of the Study:
- To determine the diagnostic significance of pectus excavatum in children for mitral valve prolapse (MVP).
- To assess the incidence of MVP in pediatric patients with varying degrees of pectus excavatum severity.
Main Methods:
- Eighty-seven pediatric patients with pectus excavatum underwent cardiac examination.
- M-mode echocardiography was utilized to diagnose mitral valve prolapse.
- Patient data including age, sex, pectus severity, and auscultatory findings were analyzed.
Main Results:
- Twenty of 87 pectus patients (23%) exhibited echocardiographic evidence of MVP.
- MVP incidence was higher in severe pectus excavatum (60%) compared to mild (18%).
- MVP was more frequent in children over 8 years old (44%) than younger children (16%).
Conclusions:
- Pectus excavatum in children is associated with a significant incidence of mitral valve prolapse.
- Severe pectus deformities and older age (≥8 years) increase the likelihood of MVP.
- Heightened clinical suspicion and cardiac evaluation for MVP are warranted in pediatric patients with pectus excavatum.
Abstract:
Eighty-seven patients with pectus excavatum underwent cardiac examination and echocardiography (M-mode) to determine the diagnostic significance of pectus in children for mitral valve prolapse (MVP). Patients' ages ranged from 1 month to 18 years with a mean age of 5.4 years. Sixty-seven were males. Twenty of the 87 pectus patients (23%) had echocardiographic evidence of MVP, whereas 11 of these had auscultatory findings of a non-ejection click or late systolic murmur, and 4 had significant mitral insufficiency. Fourteen of the 77 patients (18%) with mild pectus, and 6 of the 10 patients (60%) with severe pectus had MVP. Two of the patients (3.4%) with mild pectus and 2 of the patients (20%) with severe pectus also had significant mitral insufficiency. Ten of the 23 patients (44%) older than 8 years of age and 10 of the 64 younger patients (16%) had MVP. Although MVP was present more frequently in females (30%) than in males (21%), the difference was not statistically significant. This study indicates the high incidence of MVP in children of 8 years of age and older, especially when pectus deformity is severe. This information is particularly helpful to heighten suspicion of MVP in children with pectus excavatum.