Evidence map›Paper›PMID 42313038›Full record

ArticleJACC. Case reports2026

Pectus Excavatum-Induced Preload Insufficiency Presenting as Long-Standing Sinus Tachycardia.

Radwan Alkhatib, Fawzi Zghyer, Taha Hatab, Chadi Tabaja, Faysal Massad, Rochell Issa, Besir Besir, Shada Jadam, Daniel P Raymond, Khaled M Ziada

Abstract readCase Reports
In one paragraph

Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Radwan AlkhatibDepartment of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
Fawzi ZghyerDepartment of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Taha HatabDepartment of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
Chadi TabajaDepartment of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
Faysal MassadDepartment of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
Rochell IssaDepartment of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
Besir BesirDepartment of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
Shada JadamDepartment of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
Daniel P RaymondDepartment of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Khaled M ZiadaDepartment of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA. Electronic address: ziadak@ccf.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSevere pectus excavatum is an uncommon cause of hemodynamic compromise in adults and may present with unexplained tachycardia when preload filling is impaired by cardiac compression. CASE SUMMARY: A 65-year-old woman with long-standing palpitations presented with sinus tachycardia despite high-dose beta-blockade. Electrocardiogram and ambulatory monitoring showed sinus rhythm with marked heart rate variability. Right heart catheterization revealed low filling pressures, with a mean right atrial pressure of 1 mm Hg and preserved cardiac output. Cardiovascular magnetic resonance showed severe pectus excavatum (Haller index: 8.1) with anterior cardiac compression. Pectus-induced preload insufficiency was deemed responsible for her symptoms. She underwent a modified Ravitch repair with complete resolution of palpitations and normalization of heart rate. DISCUSSION: Chest wall deformity can cause clinically significant cardiac compression, preload insufficiency, and compensatory sinus tachycardia, even in late adulthood. TAKE-HOME MESSAGE: Severe pectus excavatum should be recognized as a reversible cause of preload insufficiency and sinus tachycardia, and surgical correction may result in symptom resolution.

Indexed as

cardiac chamber compressionpectus excavatumpreload insufficiencysinus tachycardia

Identifiers

PMID42313038
PMCPMC13643457

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