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Doctors' Answers to "Frequently Asked Questions" - Chest Concavity

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Chest concavity
Question: I was reading one of the FAQs on chest concavity. I have a prominent chest deformity. I was told back in my 20s that my heart is somewhat displaced by the deformity, but not so that I was in any danger. I wondered what mitral valve prolapse is. As a child doctors considered operating to correct this condition, but apparently decided against it. My mother always said it was because I was female and that breast development would cover the deformity. Every once in a while I experience shortness of breath and feel as if I cannot take a deep breath, but nothing else.

Answer: There are many types of congenital, or inborn, chest wall conditions. When pronounced, the positions of the underlying organs and structures can be altered. Whether or not this alteration is significant with respect to the function of the organs, should be made by you and your physician. Have you been having symptoms from this concavity all along?

You made mention of a disorder known as mitral valve prolapse, that you have had since childhood. This condition involves the mitral valve of the heart. This valve separates the left atrium (which receives oxygen-rich blood from the lungs), from the left ventricle (which pumps this blood to the body). When this valve opens blood rushes from the atrium to the ventricle, and this flow stops when the valve closes. Upon closure of the valve, however, in patients with mitral valve prolapse, a portion of this valve "bows", or bulges slightly back into the atrium chamber. There may or may not be an actual alteration in the flow of blood itself, across the valve due to this abnormality, and this murmur may be loud enough to hear on physical examination.

Patients with mitral valve prolapse (MVP) can have no symptoms whatsoever from this condition, and often find out about it incidentally late in life. When patients do experience symptoms, they can be quite varied, and include chest pain, shortness of breath both at rest and/or with activity, palpitations, dizzy spells, cough, anxiety, and indigestion.

Your shortness of breath may be due to the MVP, or perhaps due to your chest wall abnormality. A visit with your physician, and a discussion of the nature of the shortness of breath, how long it has been going on, and its severity over time, as well any possible testing deemed necessary by your physician may determine what is causing your symptom. There are treatments available for both conditions, and you may benefit from one of them. In addition, there are certain precautionary measures patients with MVP need to be aware of, including antibiotics prior to any surgical and/or dental procedure. Your physician can review these with you, as well, and explain why they are important.

Chest Concavity
Question: I have a slight chest concavity. I went to the physician and he said there was nothing I could do about it, that it was how my breastbone formed at birth. What I'd like to know is how common chest concavities are, what can be done to correct them, and what medical problems, if any, can occur because of this.

Answer: A chest concavity is medically referred to as a pectus excavatum. This is an inherited or developmental problem. It does not appear to have any consequences unless it is so major as to displace the heart and great vessels. It occurs in about 3-5% of individuals. It is strongly associated with mitral valve prolapse and most people with mitral valve prolapse will outlive their contempories considerably.
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