{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T07:54:43Z","timestamp":1790841283202,"version":"4.1.0"},"reference-count":9,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"published-print":{"date-parts":[[2009]]},"abstract":"<jats:p>Pectus excavatum is usually considered meaningless and without clinical significance. The following case may put a different complexion on the matter. A healthy 59-year-old male patient complained of progressive heart palpitations, fatigue and postural dyspnoea; bending over caused a clear increase of dyspnoea. At repeated examinations no overt abnormality or explanation was found, except a supraventricular arrhythmia and a nodal tachycardia. In the years to follow the symptoms led to considerable physical impairments. Finally, the patient himself, after searching the web, came up with a possible cause: his pectus excavatum. A lateral chest x-ray with the patient bending over and a lateral computed tomography of the thorax revealed an impression of the heart by the sternum. Ten years after the patient\u2019s signs and symptoms first appeared, a modified Ravitch procedure was carried out, after which the physical condition of the patient improved rapidly.<\/jats:p>","DOI":"10.1136\/bcr.10.2009.2329","type":"journal-article","created":{"date-parts":[[2009,12,15]],"date-time":"2009-12-15T03:35:03Z","timestamp":1260848103000},"page":"bcr1020092329","source":"Crossref","is-referenced-by-count":8,"title":["Pectus excavatum, not always as harmless as it seems: Figure 1"],"prefix":"10.1136","volume":"2009","author":[{"given":"Ron","family":"Winkens","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Guldemond","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Hoppener","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Kragten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"van Leeuwen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2009,12,14]]},"reference":[{"key":"2025042508231905000_2009.dec14_1.bcr1020092329.1","unstructured":"Lewerenz-Kemper KB . Die operative Korrektur angeborener Brustwanddeformit\u00e4ten im erwachsenen Alter [thesis]. Germany: University of M\u00fcnster, 2006."},{"key":"2025042508231905000_2009.dec14_1.bcr1020092329.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.admecli.2004.06.002"},{"key":"2025042508231905000_2009.dec14_1.bcr1020092329.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2006.05.071"},{"key":"2025042508231905000_2009.dec14_1.bcr1020092329.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(03)00441-7"},{"key":"2025042508231905000_2009.dec14_1.bcr1020092329.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(98)00316-X"},{"key":"2025042508231905000_2009.dec14_1.bcr1020092329.6","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-003-7025-5"},{"key":"2025042508231905000_2009.dec14_1.bcr1020092329.7","doi-asserted-by":"publisher","DOI":"10.1378\/chest.130.2.506"},{"key":"2025042508231905000_2009.dec14_1.bcr1020092329.8","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200003000-00019"},{"key":"2025042508231905000_2009.dec14_1.bcr1020092329.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2008.12.003"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr.10.2009.2329","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T15:23:24Z","timestamp":1745594604000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr.10.2009.2329"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009]]},"references-count":9,"alternative-id":["10.1136\/bcr.10.2009.2329"],"URL":"https:\/\/doi.org\/10.1136\/bcr.10.2009.2329","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009]]}}}