Pectus excavatum

Lucina has always considered pectus excavatum (PE) to have cosmetic or psychological sequelae without cardiovascular or respiratory compromise. Chest pain and shortness of breath appear to be commonly reported with some studies suggesting a reduced FEV1 and FVC and other lung volumes. Do these underlying recognised abnormalities explain these symptoms and impact exercise capacity? Hardie W et al [Pediatric Pulmonology 2021;56:2911–2917. DOI: 10.1002/ppul.25540] have assessed if the anatomic extent of pectus deformities [determined by the correction index (CI)] is associated with a pulmonary impairment at rest and during exercise. This team performed a retrospective review on 269 children with PE. This group completed a symptom questionnaire, cardiopulmonary exercise test (CPET), pulmonary function tests (PFT), and chest MRI. Of these patients, dyspnoea on exertion and chest pain was reported in 64% and 41%, respectively. Peak oxygen uptake (VO₂) was reduced in 30% and classified as mild in two-thirds. A pulmonary limitation during exercise was identified in less than 3%. Ventilatory limitations on PFT was found in 26% and classified as mild in 85%. Obstruction was the most common abnormal pattern (11%). There were no differences between patients with normal or abnormal PFT patterns for the CI, VO₂, or percentage reporting …