A 45 year old man presented with the complaint of palpitations on swallowing. Clinical and radiological examination showed features of straight back syndrome and pectus excavatum. [ncbi.nlm.nih.gov]

No other abnormal signs were present. 1. What are the possible diagnoses? This teenage girl gave a typical history of syncope. [medicine-on-line.com]

The incidence of these abnormal sounds (or false heart enlargement) is so unusually high when a straight back is present (or pectus excavatum, for FULL TEXT [annals.org]

[…] straight Stooping forward, feeling of falling forward Chronic back muscle pain Anteroposterior diameter of thorax is smaller resulting in compression of heart Heart symptoms: Heart palpitations Shortness of breath Dizziness Diagnosis and Tests : Clinical presentation [medindia.net]

• Falling

  Cause(s) : Congenital malformation during bone development Degenerative disk disease Vertebral compression fracture Spinal fusion surgery Symptoms : Straight back at the thoracic spine area Difficulty in standing up straight Stooping forward, feeling of falling [medindia.net]

  The plumb line can fall within 2 cm of the anterior aspect of the sacrum in patients without scoliosis or in those with idiopathic scoliosis who have not undergone corrective surgery. [roentgenrayreader.blogspot.com]

  This is depicted by the gravity line (plumb line) falling in front of the sacrum. [spineuniverse.com]

  If the plumb line falls in front of the sacral spine, this results in positive sagittal imbalance, which is seen in fixed hip flexion or flat-back syndrome. [sfspine.com]

  Symptoms In addition to the appearance of their backs, persons with flatback syndrome may also have: A sensation of falling forward Chronic pain in the back muscles Difficulty with certain daily activities Fatigue Stooping at the end of the day Many patients [cedars-sinai.edu]

• Asymptomatic

  Most patients are asymptomatic; if symptomatic, chest pain and palpitations are most common. On examination, the abnormal clinical findings simulate organic heart disease that needs to be ruled out by echocardiography and cardiac catheterization. [ncbi.nlm.nih.gov]

  Abstract A 23-year-old asymptomatic woman was referred to our hospital for further examination of a systolic ejection murmur with fixed splitting of the second heart sound auscultated at the third left sternal border. [jstage.jst.go.jp]

  […] diameter, ↑ prominence of pulmonary artery and right hilum, displacing heart to left, simulating cardiomegaly Associations ASD, scoliosis; it may cause mild pulmonary vein obstruction and dilation, evoking a harsh late systolic ejection murmur; it is asymptomatic [medical-dictionary.thefreedictionary.com]

• Inflammation

  Inflammation will result around the spine from muscular tightness which causes spinal stenosis – the narrowing of the spinal canal. [resolveyourpain.com]

  Following treatment options are mainly followed in case of lumbar lordosis, depending upon the severity: Analgesic for lessening the pain syndrome and anti-inflammatory for inflammation. [healthsurgical.com]

  Yes, stretching IS an important part of keeping everything healthy down there, but NOT when you've got serious inflammation. 5) Don't try to run through this. You'll simply make it worse. [letsrun.com]

  The excessive movement may cause nerve roots to be pinched or for excess pressure to be put on joints in the spine, leading to inflammation. [hedleyortho.com]

  Gonstead further stated that, on an AS ilium, the posterior aspect of the joint opens and will demonstrate a palpable fluidic, spongy feel, indicating inflammation and nerve irritation. [serola.net]

• Surgical Procedure

  Although there are surgical procedures available to attempt to counteract the effects of Flatback Syndrome, the surgical treatments are complex and a successful recovery is never guaranteed. Early medical intervention is key to long-term success. [spinecare.luminhealth.com]

  Fusion procedures are sometimes used when non-surgical treatments are unsuccessful. [hedleyortho.com]

  If the planned surgical procedure is anticipated to last more than 10 to 12 hours, however, staging the surgery may be preferred. [scoliosismd.com]

• Pulmonary Valve Stenosis

  […] circulation Pulmonary embolism - Cor pulmonale Pericardium Pericarditis - Pericardial effusion - Cardiac tamponade Endocardium / heart valves Endocarditis - mitral valve ( regurgitation, prolapse, stenosis ) - aortic valve ( stenosis, insufficiency ) [wikidoc.org]

• Dyspnea

  History § Most common complaints are palpitation, non-cardiac chest pain, and dyspnea following exertion. These symptoms can occur either alone or in combination. Syncope is less common. [medicine-on-line.com]

  Symptoms of chest pain, dyspnea, anxiety, and panic [11] are probably no more common with MVP than in the general population. Mitral valve prolapse. A patient with straight back syndrome. [emedicine.medscape.com]

• Cough

  There is persistent cough that is especially worse at night. Since sinusitis is commonly caused by upper respiratory tract infections, this is a common finding. There may be a persistent sore throat indicating an upper respiratory tract infection. [news-medical.net]

  Some patients find pain worsens when they cough or sneeze. Diagnosis: Diagnosing thoracic disc herniation can be difficult, as the symptoms patients tend to report could have a root cause in other areas of the body besides the spinal cord. [hedleyortho.com]

• Nausea

  You may not have chest pain at all but instead have shortness of breath, nausea, or a strange feeling in your chest or other areas. Seek Care Today Based on your answers, you may need care soon. [northshore.org]

  Each episode lasted 2 – 3 minutes and accompanied by nausea, perspiration, and pallor but not by incontinence or convulsion. These symptoms disappeared with rest. [medicine-on-line.com]

• Vomiting

  Nausea or vomiting. Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms. Lightheadedness or sudden weakness. A fast or irregular heartbeat. [northshore.org]

• Ejection Murmur

  murmurs, and failed back surgery. [medical-dictionary.thefreedictionary.com]

  An asymptomatic 45-year-old man was referred to our hospital for detailed evaluation of a systolic ejection murmur. [ncbi.nlm.nih.gov]

  Abstract A 23-year-old asymptomatic woman was referred to our hospital for further examination of a systolic ejection murmur with fixed splitting of the second heart sound auscultated at the third left sternal border. [jstage.jst.go.jp]

  Cardiac features included pulmonic ejection murmurs, palpable left parasternal systolic impulses, loud delayed sounds of tricuspid valve closure, exaggerated respiratory splitting of the second heart sound, vertical electrical axes, rSr' patterns in leads [circ.ahajournals.org]

• Heart Murmur

  Murmurs were invariably systolic in nature. Those located at the base of the heart in 19 (38%) patients were ejection in type and best heard during expiration. [ncbi.nlm.nih.gov]

  Clinical features: (1) variable chest pain (2) variable palpitations (3) often a family history with an autosomal dominant inheritance (4) systolic heart murmur (5) physiologic splitting of the second heart sound Changes seen in the ECG may include: [meducator3.net]

  Many of these patients were referred for cardiological assessment because of heart murmurs and subsequently found to have no organic heart disease. That is why the syndrome was called “ pseudo-heart disease ” when first reported. [medicine-on-line.com]

  Michael Gibson, M.S., M.D. [1] ; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2] Synonyms and Keywords: SBS Overview The straight back syndrome, consisting of loss of normal upper thoracic spinal curvature associated with heart murmurs and radiographic [wikidoc.org]

• Tachycardia

  […] compression or ‘pancaking’ of the heart between the sternum and spine and may produce a “radiographic cardiomegaly” Clinical Considerations • Most are asymptomatic • May be a systolic ejection murmur • 50-64% associated with mitral valve prolapse • Tachycardia [proxraymanagement.com]

  […] branch block ( Left, Right ) - Bifascicular block - Trifascicular block Pre-excitation syndrome ( Wolff-Parkinson-White, Lown-Ganong-Levine ) - Long QT syndrome - Adams-Stokes syndrome - Cardiac arrest - Sudden cardiac death Arrhythmia : Paroxysmal tachycardia [wikidoc.org]

  Arrhythmic profile, ventricular function, and histomorphometric findings in patients with idiopathic ventricular tachycardia and mitral valve prolapse: clinical and prognostic evaluation. Clin Cardiol. 1998 Oct. 21 (10):731-5. [Medline]. [emedicine.medscape.com]

• Systolic Murmur

  Low grade systolic murmurs and non-ejection clicks are common but not systolic thrill. [medicine-on-line.com]

• Hypertension

  PMID 18165751 v t e Circulatory system pathology ( I, 390-459 ) Hypertension Hypertensive heart disease - Hypertensive nephropathy - Secondary hypertension ( Renovascular hypertension ) Ischaemic heart disease Angina pectoris ( Prinzmetal's angina ) - [wikidoc.org]

• Lordosis

  Benign juvenile lordosis is the condition where more prominent lordosis occurs in children, but this deformity is corrected naturally with increasing of age. Spondylolisthesis can also cause lordosis. [healthsurgical.com]

  Normal cervical lordosis is from 20° to 40°. Normal thoracic kyphosis is from 20° to 40°. Normal lumbar lordosis is from 30° to 60°. Lordosis at the L5-S1 level is very important in that it contributes up to 47% of lumbar lordosis. [sfspine.com]

  In the lumbar spine, these discs contribute to normal lordosis. As the discs degenerate, the spine stiffens, and lordosis lessens. The patient has progressive difficulty in achieving upright posture. [spineuniverse.com]

  […] lumbar lordosis are not taken. [scoliosismd.com]

  Back Pain > Lordosis > Flat Back [cure-back-pain.org]

• Back Pain

  He is complaining about back pain, that bothers him after he walks a little. I also saw that his back isn't straight and looks like a S. is this deformity connected to his back pain? A. [medical-dictionary.thefreedictionary.com]

  Back Pain > Lordosis > Flat Back [cure-back-pain.org]

  Flat back syndrome is a term used to describe lack of curvature in the low back. Sometimes people are told that flat back syndrome is the reason for their chronic low back pain. Having a flat back is a symptom of low back pain but not a cause. [resolveyourpain.com]

  The spines of people with failed back surgery syndrome are no longer in a healthy alignment. Symptoms of FBSS include: Back pain outside the original surgery area Difficulty moving Numbness Sharp or stabbing back pain 3. [utswmedicine.org]

  Most patients complain of low back pain and increasing difficulty maintaining an upright posture. The low back pain is related in part to fatigue of the low back muscles. [cincinnatispinesurgeon.com]

• Fracture

  Cause(s) : Congenital malformation during bone development Degenerative disk disease Vertebral compression fracture Spinal fusion surgery Symptoms : Straight back at the thoracic spine area Difficulty in standing up straight Stooping forward, feeling [medindia.net]

  Vertebral Compression Fractures: Compression fractures are often the result of weak spinal bones due to osteoporosis. A fracture can lead to loss of height of the bone in the thoracic and lumbar spine. [spinemd.com]

  Traumatic (Fractures, Dislocations, Muscle Strains, Ligament Sprains) Cause: Trauma to the spine and surrounding structures should be taken very seriously. In the case of spinal fracture, for example, urgent care is required. [hedleyortho.com]

  Kyphotic deformity can be caused by: Arthritis of the spine Birth defects Fractures of the vertebrae Muscular dystrophy Poor posture, most often in teens Spinal tumor Treatment for spinal deformities I refer to spinal deformities as common and complex [utswmedicine.org]

  Here are a few of the conditions, injuries, and other factors that can contribute to flatback syndrome: Degenerative Disc Disease Spinal Compression Fractures Ankylosing Spondylitis Spinal Stenosis Failed Previous Spine Surgery Treating Flatback Conservative [inspiredspine.com]

• Arthritis

  Symptoms also include Chronic back and neck pain Chronic fatigue Achiness in the hips, groin, or thighs Stopping forward posture Lack of balance There are multiple conditions that could bring on flat back syndrome Degenerative disk disease/arthritis Precious [nyboneandjoint.com]

  The condition can also result from arthritis of the spine or spinal fusion surgery. Diagnosis A diagnosis is based on the patient's medical history and a physical examination. [cedars-sinai.edu]

  Ankylosing Spondylitis: Ankylosing spondylitis (AS) is a chronic inflammatory disease that causes stiffness and arthritis throughout the entire spine. [spinemd.com]

  Flat back syndrome is associated with spinal stenosis, lumbar disc herniation, disc degeneration, arthritis, and chronic low back pain. Flat back causes Tightness in the lower body muscles causes the lumbar region to lose its natural curve. [resolveyourpain.com]

  Extreme arthritis also causes lordosis. [healthsurgical.com]

• Osteoporosis

  This posture condition can be caused by many different things including osteoporosis, kyphosis, obesity, and pregnancy. [braceability.com]

  Vertebral Compression Fractures A collapse of a single or multiple vertebra, the building blocks of the spine, often due to osteoporosis, may result in loss of lordosis and flatback. [spineuniverse.com]

  Calcium deficiency which leads to osteoporosis is another reason of the development of lordosis Bone cancer or osteosarcoma may cause lordosis Increasing BMI, more than 30 is one of the symptoms of obesity and leads to lordosis. [healthsurgical.com]

  Flat back syndrome can develop due to: Degeneration of spinal disks as part of the aging process Fractures of the vertebrae, often due to osteoporosis (a weakening of the bones) Harrington spinal rods, which were used to treat scoliosis between the 1960s [utswmedicine.org]

  Vertebral Compression Fractures: Compression fractures are often the result of weak spinal bones due to osteoporosis. A fracture can lead to loss of height of the bone in the thoracic and lumbar spine. [spinemd.com]

• Aura

  Mitral valve prolapse and abnormalities of haemostasis in children and adolescents with migraine with aura and other idiopathic headaches: a pilot study. Acta Neurol Scand. 2010 Aug. 122 (2):91-6. [Medline]. [emedicine.medscape.com]

Treatment: Treatment may not be necessary for thoracic disc herniation – especially if symptoms are mild or nonexistent. [hedleyortho.com]

Treatment Usually mild lumbar lordosis not required any treatment, as it does not create any trouble. But in severe cases, doctors may recommend wearing a back brace and even surgical intervention. [healthsurgical.com]

Results of Surgical Treatment The results of surgical treatment for flat back syndrome correlate closely with the adequacy of sagittal realignment and the attainment of a solid arthrodesis. [scoliosismd.com]

L4 L5 S1 low back pain treatment and the psoas muscle C4 C5 C6 C7 Cervical Disc disease. Resolving Chronic Neck Pain. Corrective scoliosis treatment. Is scoliosis curable? Yes! Written by Anthony Ohm is a pain specialist and a sports therapist. [resolveyourpain.com]

When we start talking treatment, the first step is to “put a face with the name” of the condition. We show patients images of their spines to help them understand the cause of their pain and how treatment will help. [utswmedicine.org]

Masayuki Kambe Differential Diagnosis Pectus excavatum defect Treatment Monitor if mitral valve prolapse is present Prognosis Good, even if associated with mitral valve prolapse Straight Back Syndrome. [learningradiology.com]

Prognosis Mortality/morbidity In general, mitral valve prolapse (MVP) is initially a benign disorder, and in most situations, the prognosis is excellent. [emedicine.medscape.com]

The etiology is unknown, there is literature to suggest an autosomal dominant inheritance and that relatives should be screened. This should not be confused with ‘Flat Back Syndrome’ used in some literature relative to the lumbar spine. [proxraymanagement.com]

But far and away the most common etiological factor would be the use of distraction instrumentation in the lumbar spine. Q: What are spine surgeons doing about this? A: Most-but not all-spine surgeons now know that this is something you don't do. [scoliosis.org]

Etiology Most cases of mitral valve prolapse (MVP) are primary, idiopathic in nature, and expressed as an autosomal dominant trait that exhibits both sex- and age-dependent penetrance. [18] Connective tissue disorders Connective tissue conditions that [emedicine.medscape.com]

Pathogenesis of Flat Back Syndrome This postural disorder is a syndrome and therefore represents a spectrum of etiologic and aggravating factors. [scoliosismd.com]

Epidemiology United States data Mitral valve prolapse (MVP) can be identified by echocardiography in an estimated 0.3% [5] to 3% of the general population, and it is identified in 7% of autopsies. [emedicine.medscape.com]

Pathophysiology A myxomatous degeneration from collagen dissolution leads to excess mucopolysaccharides in the middle spongiosa layer of the mitral valve leaflets, resulting in stretching of the leaflets and the chordae tendineae. [emedicine.medscape.com]

Most scoliosis spinal surgeries done today use newer technologies and innovative procedures to help prevent Flatback Syndrome. [spinecare.luminhealth.com]

Discussion: - results from arthrodesis w/ distraction involving lower lumbar spine; - young patients can compensate via flexion of hips & knees; - adults > 40 years loss ability to compensate & go on to develop fatigue-like pain along w/ a stooped posture; - Prevention [wheelessonline.com]

Prevention of Flat-Back Syndrome The most effective treatment for flat-back syndrome is to prevent its occurrence. [scoliosismd.com]

Q: In addition to using segmental instrumentation, what else are surgeons doing to prevent this problem? A: We know the importance of maintaining the patient's lordosis during surgery. [scoliosis.org]

For a number of years following surgery, patients are able to compensate with the normal discs below the fusion, but after a number of years, those discs degenerate and prevent the patient from standing upright comfortably. [scoliosisassociates.com]