Patients with Pectus Excavatum commonly report symptoms of compromised exercise function, yet cardiopulmonary function tests (CPET) fail to demonstrate a pathophysiological cause. As a result, patients in England are refused surgical treatment. We have examined whether categorised values of maximal oxygen consumption and other CPET parameters enable definition of exercise dysfunction. Results demonstrate that the analysis of categorised maximal oxygen consumption demonstrate that > 50% of patients with Pectus Excavatum experience compromised exercise function and >80% experiencing ventilatory dysfunction. Ventilatory dysfunction appears to be the primary cause of compromised cardiovascular function. Categorised data revealed that surgical treatment reduces exercise dysfunction by 40%, increasing the incidence of those with normal function by 90%. In conclusion use of CPET and pulmonary function tests require use of normal referenced and subgroup analysis to define physiological disturbances. This may improve access of patients with pectus to surgical treatment.
