Jaroszewski Dawn E, Aly Mohamed R, Shawwaf Kenan A, Jenkins J Asher, Moosavi Ryan, Zeineddine Rawan M, Khedr Ahmed E, Sandstrom Beth, Cortez Chona, Farina Juan M
Department of Cardiovascular and Thoracic Surgery, Mayo Clinic, Phoenix, AZ, USA.
J Thorac Dis. 2024 Dec 31;16(12):8565-8581. doi: 10.21037/jtd-24-1325. Epub 2024 Dec 27.
Pectus excavatum (PE) can cause cardiopulmonary compression with a wide range of symptoms and psychosocial effects. Few validated surveys assess the extensive symptomatology of the adult pectus population. A comprehensive symptom survey was developed and validated with outcomes presented.
An observational and validation study of a novel symptom survey [Phoenix Comprehensive Assessment of Pectus Excavatum Symptoms (PCAPES)] was performed that included patients evaluated for PE from October 2020-September 2021 at Mayo Clinic Arizona. Survey validation was performed in three phases.
After survey validation, 432 patients completed the PCAPES survey: median age was 30 years [interquartile range (IQR), 23.0, 39.9 years], 57.8% males, median Haller index: 4.2 (IQR, 3.6, 5.4). Common neurological complaints included headaches (74%) and positional dizziness (67%). Regarding cardiovascular symptoms, 6/7 exercise related questions had at least 70% of patients reporting limitations or inability to perform. Pulmonary-wise, >80% noted restricted breathing both with normal activity and during exercise. For gastrointestinal symptoms, nearly half reported some degree of dysphagia with 52% noting post-prandial dyspnea. Psychosocially, patients reported either avoiding activities where their chest could be visible (68%) or feeling bothered by the overall appearance of their chest (80%). Commonly reported complaints were feelings of depression and anxiety (65% each). Females and older patients (≥30) were more severely affected with cardiac symptoms (P<0.05 for all comparisons). Despite being more symptomatic, females were more likely to feel dismissed by their physicians.
Pectus causes a variety of symptoms, and a comprehensive survey should be performed for assessment and indication of further testing.
漏斗胸（PE）可导致心肺受压，产生一系列症状及心理社会影响。很少有经过验证的调查评估成年漏斗胸患者的广泛症状。我们开发并验证了一项综合症状调查，并展示了相关结果。
对一项新型症状调查[漏斗胸症状的凤凰城综合评估（PCAPES）]进行了观察性和验证性研究，纳入了2020年10月至2021年9月在亚利桑那州梅奥诊所接受PE评估的患者。调查验证分三个阶段进行。
在调查验证后，432名患者完成了PCAPES调查：中位年龄为30岁[四分位间距（IQR），23.0，39.9岁]，男性占57.8%，中位哈勒指数：4.2（IQR，3.6，5.4）。常见的神经症状包括头痛（74%）和体位性头晕（67%）。关于心血管症状，7个与运动相关的问题中，至少70%的患者报告有运动受限或无法进行运动的情况。在肺部方面，超过80%的患者指出在正常活动和运动时呼吸受限。对于胃肠道症状，近一半的患者报告有某种程度的吞咽困难，52%的患者指出餐后呼吸困难。在心理社会方面，患者报告要么避免胸部可能被看到的活动（68%），要么对自己胸部的整体外观感到困扰（80%）。常见的报告症状是抑郁和焦虑情绪（各占65%）。女性和老年患者（≥30岁）受心脏症状的影响更严重（所有比较P<0.05）。尽管症状更明显，但女性更有可能觉得医生对她们的病情不予重视。
漏斗胸会引起多种症状，应进行全面调查以评估并指导进一步检查。
