Case of the Week: Top 5 2020 Competition-New Murmur in A Patient With Pectus Deformity

New Murmur in A Patient With Pectus Deformity

Video Transcription

Video Summary

A 14-month-old boy with progressive pectus carinatum was evaluated for a new murmur and possible connective tissue disorder. Exam showed a harsh systolic ejection murmur, wrist sign, and pes planus, but no clear Marfan features. Echocardiography and cardiac MRI revealed anterior chest wall compression of the right ventricular outflow tract, causing flow acceleration and mild subpulmonary stenosis; the pulmonary valve was normal. Cardiac size and function were otherwise normal. The case highlights how pectus deformities can produce clinically significant cardiac obstruction, and how CMR helps assess dynamic RVOT compression and guide management.

Keywords

pectus carinatum

right ventricular outflow tract

cardiac MRI

subpulmonary stenosis

connective tissue disorder