About Pectus Excavatum (Funnel Chest or Sunken Chest)
Pectus excavatum, also known as sunken chest, occurs when the breastbone grows inward during development of the baby in the womb. The exact cause is unknown, but it is believed to be due to abnormal growth of the ribs and cartilage. The underlying causes of pectus excavatum are:
- Unusual growth of ribs and cartilage while the baby is developing in the womb causes the breastbone to push inward.
- The failure of the breastbone to join together normally causes a sunken appearance at the point where the ribs connect.
Non-modifiable risk factors, which are factors that cannot be controlled to reduce the risk of developing the condition, include:
- Sex: Male infants are up to five times more likely to develop pectus excavatum than females.
- Family history: Approximately 43% of people with pectus excavatum have a family history of the condition.
Modifiable risk factors, which are factors that can be controlled to reduce the risk of developing the condition, have not been identified for pectus excavatum.
- It's important to note that while these risk factors may increase the likelihood of developing pectus excavatum, they do not guarantee its occurrence. If you have concerns about pectus excavatum, it's best to consult with a healthcare professional for an accurate diagnosis and appropriate management.
The most common early symptoms of pectus excavatum include:
- Shortness of breath when exercising
- Chest pain
- Fatigue
- Sensation of a rapid or irregular heartbeat
- Tachycardia
As pectus excavatum progresses or becomes more severe, additional symptoms may occur, such as:
- Wheezing when exercising
- Asthma or upper respiratory tract infections
- Fainting or dizziness
- Feeling unable to exercise
- Unpleasant sensation of fullness in the stomach
- Anxiety and low body image
It's important to note that the severity of symptoms can vary from person to person, and some individuals may not experience any symptoms at all. If you are experiencing any of these symptoms or have concerns about pectus excavatum, it is recommended to consult with a healthcare professional for a proper evaluation and guidance on management options.
To diagnose pectus excavatum, the following examinations, tests, and procedures are commonly performed:
- Physical exam: The healthcare provider will examine the chest for physical signs of pectus excavatum, such as the presence of a sunken or concave appearance.
- Medical history: Gathering information about your medical history and any previous diagnoses can provide important insights.
- Lab tests: Blood tests may be ordered to check for any underlying conditions or abnormalities that could contribute to pectus excavatum.
- Imaging studies: X-rays, MRI and CT scans may be recommended to visualize the chest wall and assess the severity of the condition. These studies provide detailed images of the chest to evaluate how sunken the chest wall is and assess any associated abnormalities.
- Cardiac evaluation: An electrocardiogram (ECG) or echocardiogram may be performed to assess heart function and detect any heart abnormalities.
- Pulmonary function tests: These tests measure lung capacity and function to evaluate any respiratory issues associated with pectus excavatum.
It's important to consult with your healthcare provider regarding which specific examinations, tests, and procedures are appropriate for your individual situation.
The main treatment for pectus excavatum is surgery, which may involve placing a metal bar under the sternum to elevate it or using other techniques to reshape the chest wall. Other treatments may include pain management strategies, such as patient-controlled intravenous analgesia (PCIA) or ultrasound-guided intercostal nerve blocks, to manage postoperative pain effectively.
The goals of treatment for pectus excavatum are:
- Correct the chest deformity: The main goal is to correct the sunken chest wall and restore a more normal shape and appearance to the chest. This is typically achieved through surgical procedures such as the Nuss procedure or the Ravitch procedure.
- Improve lung function: Pectus excavatum can sometimes restrict lung capacity, leading to breathing difficulties. The surgical correction of the chest deformity can help improve respiratory function and increase lung capacity.
- Alleviate symptoms: Pectus excavatum can cause symptoms like chest pain, shortness of breath, and exercise intolerance. Treatment aims to alleviate these symptoms by correcting the chest deformity and improving overall lung function.
- Enhance quality of life: Pectus excavatum can have a negative impact on a person's self-esteem and body image. Treatment aims to improve the patient's quality of life by addressing the physical appearance of the chest and boosting self-confidence.
It is important to note that specific medication types, therapies, therapeutic procedures, or health behavior changes beyond surgery are not commonly recommended for treating pectus excavatum. However, it is always best to consult with a healthcare professional for personalized advice and recommendations based on individual circumstances.
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Side effects can occur. Check with your health care professional or read the information provided with your medication for side effect information.