Clinical Evaluation of Pectus Excavatum in Active Duty Military Patients

The evaluation of patients with pectus excavatum (PE) has focused more on the pediatric population who may undergo surgical correction of sternal defects. Limited data in the medical literature exists on the evaluation of adults with PE. This study evaluated the type of evaluation conducted, clinical findings, and outcomes in a military population.

A retrospective chart review of active duty military personnel with a diagnosis of pectus excavatum was conducted. Clinical data included pulmonary function testing, chest imaging, cardiac imaging, and formal exercise testing. Determination was made for associated conditions and if PE was limiting to continued service in the military.

Ninety-five unique active duty individuals with a diagnosis of PE and documented spirometry between 2005 and 2020 were identified. The cohort was predominantly male (90%) and Caucasian (83%). Time in service was 6.7 ± 5.2 years. Pulmonary function testing values included normal forced vital capacity (FVC) of 85.5 ± 15.5%; forced expiratory volume at 1 second (FEV1) of 81.4 ± 15.1%, FEV1/FVC ratio of 0.79 ± 0.10, total lung capacity of 88.8 ± 20.3%, and diffusing capacity of 91.3 ± 15.4%.

In the active duty military population identified with PE, evaluation should include lung function, chest and cardiac imaging, and exercise testing to determine if there are limitations to mandatory fitness requirements. In the absence of other cardiac or pulmonary findings, the presence of PE itself usually does not affect military service.