A 24-year-old man was hospitalized for evaluation of an aortic-root aneurysm

Correct Answer :

Explanation :

This patient has pectus excavatum, the most common congenital deformity of the chest wall.

The primary problem is a deformity of the costal cartilages which develop in a concave position and depress the sternum towards the vertebral column. The condition is usually apparent at birth and worsens with time. It may be familial.

The features of pectus excavatum vary widely:

• features may be very mild and barely noticeable deformity to one in which there may be severe cardiac and respiratory insufficiency
• a sharp posterior concavity in the body of the sternum usually deepest just above the xiphoid process and extending to the sternomanubrial junction
• the sternum may be depressed close to the vertebral column
• heart often displaced to the left
• extent of cardiac depression is visible on CT scan

Created by USMLE PlAB MCQ