Elsevier

British Journal of Diseases of the Chest

Volume 53, Issue 2, April 1959, Pages 151-152, IN9-IN10, 153-158
British Journal of Diseases of the Chest

Chest deformities in congenital heart disease

https://doi.org/10.1016/S0007-0971(59)80005-XGet rights and content

Summary

The chest deformity associated with the A.S.D. differs clinically and radiologically from that of the V.S.D. In A.S.D. there is a unilateral bulge which lies directly over the right ventricle and is considered to be due directly to the pressure of this enlarged chamber. In V.S.D. there is a bilateral upper sternal protuberance, the antero-posterior diameter of the chest is increased, and there is a tendency for the lower ribs to be drawn in on inspiration.

The “V.S.D. type” deformity was found, on a radiological basis, in one-half of 45 cases of V.S.D. in whom an adequate lateral X-ray of the chest was available, together with cardiac catheterisation data. Thus, the incidence of the “V.S.D. type” deformity in cases of V.S.D. is approximately the same as that of the “A.S.D. type” deformity in cases of A.S.D.

In the V.S.D., the deformity, which is similar to a pigeon-breast deformity, was associated in most cases with pulmonary hypertension. It is considered to be much commoner when the pulmonary vascular resistance is raised than when it is not. It occurs in the “Eisenmenger syndrome” in only a minority of cases.

It is suggested that the deformity of the V.S.D. may be due to changes in the mechanical properties of the lungs, and that the combination of increased pulmonary vascular resistance and increased pulmonary blood flow increases the stiffness of the lungs.

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