The straight back syndrome

Another cause of innocent systolic murmurs
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      A thirty-three year old Negro man was referred to us because of a systolic murmur at the base of the heart and roentgenologic and electrocardiographic findings suggestive of left ventricular hypertrophy. After careful evaluation of the patient, no evidence of organic heart disease was found and a diagnosis of the “straight back” syndrome was established.
      The straight back syndrome has recently been described as “a new cause of pseudoheart disease.” This deformity, together with other thoracic malformations, may mimic organic heart disease when a systolic murmur occurs in conjunction with a distorted cardiac silhouette and/or an abnormal electrocardiogram, unless the significance of the deformity is recognized.
      Compression of the heart between the straightened thoracic spine posteriorly and the sternum anteriorly, with distortion of the right ventricular outflow tract, appears to be the mechanism by which this deformity produces “pseudo-heart disease.” The importance of its being recognized by physicians is emphasized.
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