Straight back syndrome

Associate Editor-In-Chief:

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. 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.

Historical Background
Straight back syndrome first diagnosed and reported by Rawlings in 1960.

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

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