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]

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]

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]

  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]

• Renal Artery Stenosis

  artery stenosis ) - Aortic dissection / Aortic aneurysm ( Abdominal aortic aneurysm ) - Aneurysm - Raynaud's phenomenon / Raynaud's disease - Buerger's disease - Vasculitis / Arteritis ( Aortitis ) - Intermittent claudication - Arteriovenous fistula [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]

  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]

• Mitral Valve Prolapse

  The literature on straight back syndrome is reviewed and its association with mitral valve prolapse discussed. [ncbi.nlm.nih.gov]

  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]

• Ejection Murmur

  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]

• Intracranial Hemorrhage

  hemorrhage / cerebral hemorrhage : Extra-axial hemorrhage ( Epidural hemorrhage, Subdural hemorrhage, Subarachnoid hemorrhage ) Intra-axial hematoma ( Intraventricular hemorrhages, Intraparenchymal hemorrhage ) - Anterior spinal artery syndrome - Binswanger's [wikidoc.org]

• Right Bundle Branch Block

  The electrocardiogram showed incomplete right bundle branch block and a vertical QRS axis. [academic.oup.com]

  bundle branch block (2) vertical QRS axis The murmur may be a benign flow murmur or it may be due to an underlying valve disorder. [meducator3.net]

• 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]

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]

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]

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]