Pectus Excavatum

Pectus excavatum [PEK-tis EKS-kuh-VAH-tuhm] — also known as funnel chest — is a chest wall deformity where the breastbone (the bones near the top of your chest that cover your heart and lungs) sinks into the chest. This happens because the connective tissues in the chest don’t grow the right way, and can’t hold the breastbone forward all the way.

Usually, doctors or parents will notice this condition soon after a child is born, but it can get worse during adolescence when children grow faster.

If pectus excavatum is not severe, you might only notice a small indentation in the chest. However, if it is more severe, the area around the sternum can look like it has been dented in several inches. Very severe cases of pectus excavatum can compress the lungs and heart, causing serious health risks.

Pectus excavatum is more common in boys and in people who have certain other conditions that can be passed down through families (inherited) like:

• Marfan [MAHR-fan] syndrome. This disorder affects the body’s connective tissues.
• Ehlers-Danlos [EY-lerz DAN-los] syndrome. This disorder weakens connective tissues.
• Osteogenesis imperfecta [os-tee-oh-JEN-uh-sis ihm-puhr-FEK-tuh]. This disorder causes bones to break easily.
• Noonan [NOO-nan] syndrome. This disorder causes many parts of the body to develop abnormally.
• Turner syndrome. This disorder affects a girl’s development, causing her to be short in height and have ovaries that don’t work properly.

The symptoms of pectus excavatum depend on how serious the condition is, and will be different for each person. If you or your child has a minor case of this condition, the only symptom might be a slight indentation in the chest. This might get worse as a child goes through adolescence and becomes an adult.

In more serious cases of pectus excavatum, the breastbone sinks into the chest more deeply. This can push on the heart and lungs, causing other symptoms like:

• Not being able to exercise
• Fast heartbeat or a heart that skips a beat
• Colds and respiratory infections
• Coughing
• Pain in your chest
• Tiredness

Because pectus excavatum can get worse as a child gets older, these symptoms might not appear until adolescence or adulthood.

Even a mild case of pectus excavatum can cause people, especially children and adolescents, to become depressed, angry, and have problems with their self-image because they look different from their peers and friends.

See a doctor if your child has a sunken chest. Your doctor can talk to your child about pectus excavatum and can recommend treatment for severe cases of the condition.

There is no known cause of pectus excavatum. Scientists think that this condition might be inherited because it can be passed down in families. Boys have this condition more often than girls, and people with certain conditions can also be at a higher risk.

Sometimes, you can identify pectus excavatum on your own just by looking at your chest, or your child’s chest, for an indentation. Your doctor can also usually diagnose this condition just by looking at the chest. There are other tests and scans your doctor might request to get a better view of this condition. These can include:

• Chest x-rays. This imaging test involves taking pictures of the bone and organs inside of the chest.
• A CT scan. A CT scan takes x-rays from many angles to create a more detailed picture of the inside of the body.
• Electrocardiogram [ih-LEK-trow-KAR-dee-oh-GRAM]. This test monitors the electrical signals in the heart to see if a heartbeat is regular, and if there any problems with the heart pumping.
• Echocardiogram [eh-koh-KAR-dee-oh-GRAM]. An echocardiogram uses sound waves that bounce off of the organs inside of the body to take pictures and videos of the heart.
• Lung function tests. These tests can measure how much air you or your child can hold in your lungs, and how fast the air can get pushed out of the lungs.
• Exercise test. This test checks how well the heart and lungs function during exercise.

If you or your child have a moderate to severe case of pectus excavatum, your doctor might recommend surgery. There are two kinds of surgery that are generally used to treat this condition:

• Smaller incision. During this surgery, the surgeon makes two small incisions (cuts) under each arm. Long tools and a camera are placed through the incisions. The surgeon then puts a small metal bar along the chest wall, putting it into a more typical position.
• Larger incision. The surgeon makes a large incision in the center of the chest so that they can look at the breastbone directly. The cartilage (connective tissue) that connects the ribs to the breastbone is removed, and the surgeon uses metal bars and other tools to move the breastbone to a typical position.

Even if your doctor doesn’t recommend surgery, you might want to talk to them about emotional support. Pectus excavatum is a difficult condition for children because it makes them look different from their peers and friends. If your child has this condition, counseling can help them get better at dealing with this condition and socializing with others.

Pectus excavatum can’t be prevented because doctors don’t know what causes it. If you think that your child has this condition, treatments are available to reduce serious symptoms. Talk to a doctor to find out about treatment options.