Thoracic collapse deformity

Introduction Thoracic collapse deformities are common in funnel chests. The signs of the funnel chest, the sternum (especially the root of the xiphoid) and its corresponding 3rd to 6th costal cartilage are inward, causing the front chest wall to resemble a funnel, and the heart is displaced. The funnel chest is a congenital and often familial disease. Men are more common than women, and there are reports that the ratio of men to women is 4:1, which is a companion dominant inheritance. The incidence of funnel chest in family history was 2.5%, while in those without family history, the incidence of funnel chest was only 1.0%.

Cause

Causes of thoracic collapse deformity

Men are more common than women, and there are reports that the ratio of male to female is 4:1, which is a companion dominant inheritance. The incidence of funnel chest with a family history was 2.5 , and the incidence of funnel chest was only 1.0 without family history. The cause of the funnel chest is unknown and is believed to be related to heredity.

Some people think that this deformity is due to the uncoordinated growth of the ribs, the lower part is smaller than the upper part, and the sternum is extruded backwards. It is also thought that the sternum is attached to the lower end of the sternum and the xiphoid in front of the iliac muscle. And the xiphoid is pulled backwards.

an examination

Related inspection

Chest flat chest external examination

Examination of thoracic collapse deformity

Infants with mild fungal chest compression symptoms are often unnoticed. Some have inhalation wheezing and sternal inhalation depression, but often fail to check the cause of airway obstruction. Children often have a thin body, are not moving, are prone to upper respiratory tract infections, and their mobility is limited. Forced expiratory volume and maximum ventilation were significantly reduced. Pain, shortness of breath and difficulty breathing during activities. In addition to the thoracic deformity, the body signs often have a special shape such as mild hunchback and abdomen protruding.

Symptoms and signs:

The sternum (especially the root of the xiphoid) and its corresponding 3rd to 6th costal cartilage are inwardly trapped, causing the front chest wall to resemble a funnel, the heart is displaced by pressure, and the lung is also restricted by thoracic deformity, affecting Cardiopulmonary function of the child. After the child's activity, palpitations and shortness of breath, often upper respiratory tract and lung infection, and even heart failure. Symptoms become more obvious after 3 years of age, concave chest, convex belly, weight loss, poor development. The funnel chest is often a congenital malformation, which not only affects the adverse effects, but should accumulate treatment. The funnel chest is a kind of deformity in which the sternum, costal cartilage and a part of the ribs form a funnel shape to the spine. Most of the sternum of the funnel chest starts from the level of the second or third costal cartilage, and the lowest point of the xiphoid is slightly lower. Point, then go forward to form a ship-like deformity. Both sides or the outside are deformed inwardly to form two side walls of the funnel chest. The ribs of the funnel chest are larger than the normal ones. The ribs are recessed from the upper rear to the front and the lower, making the front and back become close. In severe cases, the deepest depression of the sternum can reach the spine. The age of the funnel chest patient is often symmetrical. As the age increases, the funnel chest deformity gradually becomes asymmetrical, the sternum tends to rotate to the right, and the right costal cartilage is often deeper than the left, the right breast. Development is worse than the left side. The posterior chest is mostly flat or round, and the scoliosis gradually increases with age. It is not easy to have scoliosis when the age is young. The scoliosis of the patient is more obvious after puberty. The funnel chest deformity oppresses the heart and lungs, and most of the heart shifts to the left thoracic cavity. Children tend to behave in a uniquely weak posture: the neck stretches forward, the rounded shoulders, and the cans. The scaphoid xiphoid junction is the deepest depression. Have a family tendency or have congenital heart disease.

X-ray examination of the heart and electrocardiogram: often the heart shifts to the left and rotates in a timely manner. X-ray chest radiograph shows that the lower sternum is recessed backward, and the distance between the spine is shortened. The CT image depression is more precise and clear. The funnel chest is very easy to diagnose clinically, and the deformity is clear at a glance. However, it is difficult to determine the severity of the funnel chest. There are many clinically described methods.

X-ray examination can see that the back of the rib is straight, the front part is tilted down forward and downward, and the heart shadow is displaced to the left chest. The middle of the heart has a distinct radiolucent area, and the right heart often overlaps the spine. Individual severe patients' heart shadows can be completely located in the left thoracic cavity, and older patients have more scoliosis in the spine. The lateral chest radiograph can be seen that the sternum is obviously bent backwards, and some of the lower sternum can reach the leading edge of the spine.

Back front photo: transparent area in the heart of the funnel chest.

Chest CT films can more clearly show the severity of thoracic deformity and the degree of cardiac compression.

The electrocardiogram can be expressed as a P wave inversion of V1 or bidirectional. There can also be right bundle branch block, and cardiac catheterization can be traced to the diastolic slope and platform, as seen with constrictive pericarditis. Cardiovascular angiography showed a right heart compression deformity and a blocked right ventricular outflow tract.

Differential diagnosis

Thoracic collapse deformity should identify congenital malformations or acquired diseases.

Infants with mild fungal chest compression symptoms are often unnoticed. Some have inhalation wheezing and sternal inhalation depression, but often fail to check the cause of airway obstruction. Children often have a thin body, are not moving, are prone to upper respiratory tract infections, and their mobility is limited. Forced expiratory volume and maximum ventilation were significantly reduced. Pain, shortness of breath and difficulty breathing during activities. In addition to the thoracic deformity, the body signs often have a special shape such as mild hunchback and abdomen protruding.

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