Presentation
Shortness of breath after long distance travel, ?PE
Patient Data
Age: 20 years
Gender: Male
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The right heart border is indistinct. The lungs are otherwise clear.
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There is no pulmonary embolism, and the lungs are clear. The heart is displaced towards the left by sternal depression due to pectus excavatum.
Case Discussion
The indistinct right heart border on the chest x-ray is accounted for the alteration of the chest wall in pectus excavatum. Another classic chest x-ray sign, not clearly seen here, is a horizontal orientation to the posterior ribs and downward sloping anterior ribs giving a 7 or reverse-7 sign.