A Heart in a Cage: Cardiac Compression and Cardiovascular Manifestations of Pectus Excavatum. A Case Report

Abstract We present the case of a 40-year-old woman with a background history of endometriosis and neurocardiogenic syncope of the vasodepressor subtype. During the course of her cardiac rehabilitation programme, a change in the clinical presentation of her syncopal episodes was observed, with the new onset of cardiovascular chest pain occurring subsequent to haemodynamic collapse. Multimodal cardiac imaging revealed significant right ventricular compression attributable to pectus excavatum. Surgical correction was subsequently undertaken, resulting in complete clinical recovery, resolution of right ventricular compression, and the absence of syncopal episodes over a two-year follow-up period. This case highlights the importance of a thorough clinical assessment combined with the judicious use of multimodal imaging in achieving an accurate diagnosis and formulating an appropriate therapeutic strategy. Ultimately, this approach led to the complete resolution of symptoms and a favourable impact on long-term survival.