Straight back syndrome

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Synonyms and Keywords: SBS

Overview

The straight back syndrome, consisting of loss of normal upper thoracic spinal curvature associated with heart murmurs and radiographic cardiomegaly is considered a form of ‘pseudoheart disease’ which has been attributed to squashing of the heart in the reduced AP diameter of the chest.[1] In another words the straight back syndrome is loss of the normal concavity of the thoracolumbar spine with a narrowed anteroposterior chest dimension, resulting compression of the heart between spine and sternum, and consequent prominent precordial pulsations, an ejection murmur, and radiologic evidence of a widened cardiac silhouette (pancaked heart).

Straight back syndrome (SBS) patients who have valvular heart disease should receive infective endocarditis prophylaxis.[2]

Historical Perspective

Straight back syndrome first diagnosed and reported by Rawlings in 1960.[3] [4]

Diagnosis

Diagnosis of Straight back syndrome is simple, which only requires AP and lateral chest x-rays.

References

  1. Davies MK, Mackintosh P, Cayton RM, Page AJ, Shiu MF, Littler WA. The Straight Back Syndrome Q J Med 1980; 49: 443-460 PMID 7267961
  2. Ansari A. The "straight back" syndrome: current perspective more often associated with valvular heart disease than pseudoheart disease: a prospective clinical, electrocardiographic, roentgenographic, and echocardiographic study of 50 patients. Clin Cardiol. 1985 May; 8 (5): 290-305. PMID 3995803
  3. Rawlings MS, The straight back syndrome. A new cause of pseudoheart disease. Am J Cardiol 1960, 5, 333-338
  4. Masajuki Kambe. Straight back syndrome and respiratory failure. JMAJ 49, 4, 176-79, 2006

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Additional Resources

  • Haswell K, Gilmour J, Moore B. Clinical decision rules for identification of low back pain patients with neurologic involvement in primary care. Spine. 2008 Jan 1; 33 (1): 68-73. Review. PMID 18165751




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