Pectus excavatum

Overview

Pectus excavatum is a condition in which the person's breastbone is sunken into the chest. In severe cases, pectus excavatum can look as if the center of the chest has been scooped out, leaving a deep dent.

While the sunken breastbone is often noticeable shortly after birth, the severity of pectus excavatum typically worsens during the adolescent growth spurt.

Also called funnel chest, pectus excavatum is more common in boys than in girls. Severe cases of pectus excavatum can eventually interfere with the function of the heart and lungs. But even mild cases of pectus excavatum can make children feel self-conscious about their appearance. Surgery can correct the deformity.

Symptoms

For many people with pectus excavatum, the only sign or symptom is a slight indentation in their chests. In some people, the depth of the indentation worsens in early adolescence and can continue to worsen into adulthood.

In severe cases of pectus excavatum, the breastbone may compress the lungs and heart. Signs and symptoms may include:

• Decreased exercise tolerance
• Rapid heartbeat or heart palpitations
• Recurrent respiratory infections
• Wheezing or coughing
• Chest pain
• Heart murmur
• Fatigue
• Dizziness

Causes

While the exact cause of pectus excavatum is unknown, it may be an inherited condition because it sometimes runs in families.

Risk factors

Pectus excavatum is more common in boys than in girls. It also occurs more often in people who also have:

• Marfan syndrome
• Ehlers-Danlos syndrome
• Osteogenesis imperfecta
• Noonan syndrome
• Turner syndrome

Complications

Severe cases of pectus excavatum can compress the heart and lungs or push the heart over to one side. Even mild cases of pectus excavatum can result in self-image problems.

Heart and lung problems

If the depth of the breastbone indentation is severe, it may reduce the amount of room the lungs have to expand. This compression can also squeeze the heart, pushing it into the left side of the chest and reducing its ability to pump efficiently. This can cause symptoms such as exercise intolerance, shortness of breath, rapid heart rate, and chest pain or pressure.

Self-image problems

Many people who have pectus excavatum will also tend to have a hunched-forward posture, with flared ribs and shoulder blades. Many are so self-conscious about their appearance that they avoid activities where their chest can be seen, such as swimming. They may also avoid clothing that makes the indentation in their chests more difficult to camouflage.