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Straight Back Syndrome


Presentation

  • 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]
  • Cardiomegaly (C:T greater than 55%) was present in only 5 (10%) and dilatation of the main pulmonary artery in 2 (4%) patients. Thus the incidence of pseudoheart disease (PsHD) was small (14%).[ncbi.nlm.nih.gov]
  • A 38 year-old man presented at a chiropractic clinic with moderate chest pain and tightness on his left side; tingling/numbness in his left arm; significant mid-thoracic pain; shortness of breath; and chronic fatigue.[chironexus.net]
  • […] 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]
  • Mason, MD now presents the fifth edition in full color with new images and highlighted clinical elements.[books.google.com]
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]
  • 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.[ncbi.nlm.nih.gov]
  • 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]
  • […] 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]
Pulmonary Valve Stenosis
  • valve ( stenosis, insufficiency ) - tricuspid valve ( stenosis, insufficiency ) Myocardium Myocarditis - Cardiomyopathy ( Dilated cardiomyopathy, Hypertrophic cardiomyopathy, Loeffler endocarditis, Restrictive cardiomyopathy ) - Arrhythmogenic right[wikidoc.org]
Lymphedema
  • , Budd-Chiari syndrome, Renal vein thrombosis, Paget-Schroetter disease ) - Varicose veins / Portacaval anastomosis ( Hemorrhoid, Esophageal varices, Varicocele, Gastric varices, Caput medusae ) - Superior vena cava syndrome - Lymph ( Lymphadenitis, Lymphedema[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]
Ejection Murmur
  • 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.[ncbi.nlm.nih.gov]
  • An asymptomatic 45-year-old man was referred to our hospital for detailed evaluation of a systolic ejection murmur.[ncbi.nlm.nih.gov]
  • […] spine and sternum, and consequent prominent precordial pulsations, an ejection murmur, and radiologic evidence of a widened cardiac silhouette (pancaked heart). straight back syndrome Straight back and flat chest syndrome A variant position due to of[medical-dictionary.thefreedictionary.com]
  • 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]
Ejection Murmur
  • 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.[ncbi.nlm.nih.gov]
  • An asymptomatic 45-year-old man was referred to our hospital for detailed evaluation of a systolic ejection murmur.[ncbi.nlm.nih.gov]
  • […] spine and sternum, and consequent prominent precordial pulsations, an ejection murmur, and radiologic evidence of a widened cardiac silhouette (pancaked heart). straight back syndrome Straight back and flat chest syndrome A variant position due to of[medical-dictionary.thefreedictionary.com]
  • 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
  • In a control group of 40 age- and sex-matched patients (26 male, 14 female, mean age 29.5 years), who also had heart murmurs but lacked straight upper dorsal spine, only 7 (17.5%) had MVP and none had BAV.[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]
  • ., 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 cardiomegaly is considered a form of ‘pseudoheart disease’ which has[wikidoc.org]
  • 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]
Systolic Murmur
  • Low grade systolic murmurs and non-ejection clicks are common but not systolic thrill.[medicine-on-line.com]
Diastolic Murmur
  • Diastolic murmurs were not heard in any patient. EKGs were normal in the majority. Cardiomegaly (C:T greater than 55%) was present in only 5 (10%) and dilatation of the main pulmonary artery in 2 (4%) patients.[ncbi.nlm.nih.gov]
Spine Pain
  • Here are some of the common symptoms of flat back syndrome: Spine pain in the neck (cervical), mid-back (thoracic) and low-back (lumbar) Pain and tightness in the buttocks and thighs.[medicalmediaimages.com]
Narrow Chest
  • A patient with a straight back tends to have a narrow chest from anterior to posterior (sagittal axis). The heart may be compressed between the sternum and vertebrae.[meducator3.net]

Workup

Pericardial Effusion
  • effusion - Cardiac tamponade Endocardium / heart valves Endocarditis - mitral valve ( regurgitation, prolapse, stenosis ) - aortic valve ( stenosis, insufficiency ) - pulmonary valve ( stenosis, insufficiency ) - tricuspid valve ( stenosis, insufficiency[wikidoc.org]
Bifascicular Block
  • 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 ( Supraventricular, AV nodal reentrant[wikidoc.org]
Ventricular Hypertrophy
  • hypertrophy ( Left, Right ) Cerebrovascular diseases Stroke - Transient ischemic attack - Intracranial hemorrhage / cerebral hemorrhage : Extra-axial hemorrhage ( Epidural hemorrhage, Subdural hemorrhage, Subarachnoid hemorrhage ) Intra-axial hematoma[wikidoc.org]
Normal Electrocardiogram
  • Organic heart disease was excluded by his normal electrocardiogram (EGG) and echocardiogram.[ncbi.nlm.nih.gov]

Treatment

  • It is a resource for chiropractic, massage, and acupuncture, as well as medical and other alternative treatment methodologies. Read More[echiropractor.org]
  • “As successfully shown in this case study, patients with SBS may not require any form of invasive treatment and often benefit from conservative care for symptomatic relief,” Gold and his colleagues concluded.[chironexus.net]
  • The first section thoroughly describes the trachea, its diseases, diagnosis, and results of treatment. The second section is a detailed surgical manual featuring descriptions of special problems and their management.[books.google.com]
  • 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]
  • 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]

Prognosis

  • 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]

Etiology

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

Prevention

  • 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]

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