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(Circulation. 1998;98:605-606.)
© 1998 American Heart Association, Inc.

Images in Cardiovascular Medicine

Pectus Excavatum With Inferior Ischemia in Right Lateral Position

Thomas A. Heitzer, MD; ; Helmut Wollschläger, MD

From the Medizinische Klinik III, Kardiologie, Universität Freiburg, Germany.

Correspondence to Thomas Heitzer, MD, Universitätskrankenhaus Eppendorf, Abteilung für Kardiologie, Martinistr 52, 20246 Hamburg, FRG.

A 56-year-old woman with pectus excavatum presented with a 2-year history of increasing chest pain only while she was lying on her right side. The ECG showed ST-segment elevation in inferior leads (A) when the patient was in the right lateral position and became normal when she turned onto her back. A CT of the thorax (B) showed the funnel-chest deformity and severe sternal depression, with close contact to the proximal part of the ascending aorta. Coronary angiography showed no coronary artery disease or any abnormality in supine position (D), but revealed proximal compression of the right coronary artery only when the patient lay on her right side (C).

Surgical treatment with repair of the chest deformity was successfully performed and made the patient angina free.

View larger version (109K): [in this window] [in a new window]   Figure 1.

Footnotes

The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1–267, Houston, TX 77030.

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