Depressed breast bone and heart valve disease

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Submitted by Dr T on October 9, 2012 – 4:16am

Question: 
Dear Doctor,My 12 year-old son was diagnosed with mild pectus and a mild leaky aortic valve after a follow up with a pediatric cardiologist for an abnormal EKG. The cardiologist said that the mild pectus has caused a slight shift in his heart, which likely caused the abnormal EKG, and the repeat EKG in his office that day was normal. The echo confirmed the leaky aortic valve, which he stressed was very mild, but that no backflow should be present in the aortic valve and for that reason he recommended a follow up with my son in 2 years. We were told that the shortness of breath and sharp chest pain with exertion that my son was experiencing that prompted the intial visit with the pediatrician was unrelated to his heart and was likely exercise induced asthma and using the inhaler was fine. The leaky valve was an incidental finding as he has had no other symptoms from this. My question is, is two years a normal recommendation for follow up? Should I get a second opinion or limit him from certain activities? The cardiologist said that he could resume normal activity, and my son is not playing any sports at this time. Are there medications for a leaky valve, or is monitoring the treatment? Also, the cardiologist said the valve was enlarged, is that because it’s leaky? And lastly, do most patients diagnosed with leaky valves require open heart surgery for repair? Thank you for your time reading and answering my questions. I wasn’t prepared for the news of this, and not sure if I should travel for a second opinion if this is typical treatment for a leaky aortic valve.

Hi Ashley,
The combination of pectus excavatum and abnormal aortic valve may eventually lead to corrective surgery, the only treatments available. Because he is still growing, it is best to delay surgery (if possible) until he is fully grown or he starts having trouble with his valve. This does not appear to be a problem at present. Pectus excavatum may be associated with other illnesses like Marfan’s syndrome, a genetic disorder. Treatment depends on carefully weighing all these and other factors in offering him the best options.
Hope this helps,
Dr T

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