Pectus Excavatum – Symptoms and Causes
Overview
Pectus excavatum creates a sunken appearance in the chest. The breastbone (sternum) dips inward, and this depression can range from mild to severe.
Deeper cases create a noticeable “scooped out” appearance in the center of the chest. The condition is sometimes called funnel chest.
The impacts of pectus excavatum extend beyond physical appearance. People with this condition may experience shortness of breath, chest pain, and heart palpitations (fast or irregular heartbeat).
These symptoms often worsen during adolescent growth spurts. For younger patients, even mild cases can affect self-image and confidence.
Doctors haven’t identified the exact cause of pectus excavatum. Severe cases can impact heart and lung function over time. The condition is typically visible from birth, though the depression may become more pronounced as a child grows.
Treatment options vary based on severity and symptoms. Surgical correction can improve both physical appearance and functional symptoms for appropriate candidates. However, surgery isn’t necessary or recommended for everyone.
Alternative treatments include specialized physical therapy techniques and external medical devices designed to help reshape the chest wall.
Healthcare providers typically evaluate each case individually to determine the most appropriate treatment approach based on symptom severity, functional impact, and patient preferences.
Symptoms
Pectus excavatum often appears as a simple depression in the chest. For some children, this depression becomes more pronounced during early puberty and may continue to deepen into adulthood.
When the breastbone pushes inward, it can put pressure on both the lungs and heart. This pressure may cause several noticeable symptoms.
People with pectus excavatum might experience:
- Heart palpitations (fast-beating, fluttering or pounding)
- Pain in the chest area
- Decreasing physical endurance over time
- Breathing difficulties during activity
- Exercise-induced wheezing
- Lightheadedness or fainting
- Recurring upper respiratory infections
- Emotional distress about chest appearance
When to Seek Medical Care
It’s important to consult a healthcare provider if you or your child shows any symptoms of pectus excavatum. Pay special attention if symptoms worsen or if the chest depression becomes more pronounced over time.
Early evaluation helps determine if treatment is necessary and can prevent potential complications.
Causes
The root cause of pectus excavatum remains uncertain. Experts believe the condition may stem from abnormal development of cartilage, the connective tissue joining the breastbone to the ribs. This irregular cartilage growth can create the characteristic sunken chest appearance.
Genetic factors likely contribute to how cartilage forms. Family history often plays a role in who develops this condition.
Risk Factors
Several factors may increase your chances of developing pectus excavatum:
- Family history of the condition
- Connective tissue disorders like Marfan syndrome, Ehlers-Danlos syndrome, or osteogenesis imperfecta
- Genetic conditions such as Noonan syndrome or Turner syndrome
These factors can affect how chest tissues develop and connect, leading to the chest wall depression seen in pectus excavatum.
Health Issues
Heart and Breathing Problems
Severe cases of chest wall depression can cause significant health problems. When the breastbone pushes inward deeply, it reduces space for the lungs to expand fully during breathing.
This compression can also affect the heart by pushing it toward the left side of the chest, reducing its pumping efficiency, and restricting normal blood flow.
These issues often lead to noticeable symptoms including decreased exercise tolerance, shortness of breath, rapid heartbeat, and chest discomfort or pressure. People with these symptoms may find physical activities challenging and might experience fatigue more quickly than others.
Body Image Challenges
The physical appearance of a sunken chest often affects posture and self-confidence. Common physical traits include:
- Forward-hunched posture
- Outward flaring of lower ribs
- Rounded shoulders
These visible differences can lead to emotional and social difficulties. Many individuals feel self-conscious about their appearance and may:
- Avoid activities that expose the chest, such as swimming
- Choose clothing that conceals their chest shape
- Experience anxiety in social situations
These body image concerns can significantly impact quality of life and social interactions.
