Pectus excavatum is a condition in which a person's breastbone is sunken into his or her 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.
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:
While the exact cause of pectus excavatum is unknown, it may be an inherited condition because it sometimes runs in families.
Pectus excavatum is more common in boys than in girls. It also occurs more often in people who also have:
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.
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.
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, such as swimming, that make the indentation in their chests more difficult to camouflage behind clothing.
Pectus excavatum can usually be diagnosed simply by examining the chest. Your doctor may suggest several different types of tests to check for associated problems with the heart and lungs. These tests may include:
Pectus excavatum can be surgically repaired, but surgery is usually reserved for people who have moderate to severe signs and symptoms. People who have mild signs and symptoms may be helped by physical therapy. Certain exercises can improve posture and increase the degree to which the chest can expand.
If the depression of your breastbone isn't causing any symptoms but you're unhappy with how it looks, you could talk to a surgeon about having a silicone insert — similar to a breast implant — placed under your skin to fill in that space.
The two most common surgical procedures to repair pectus excavatum are known by the names of the surgeons who first developed them:
Most people who undergo surgery to correct pectus excavatum are happy with the change in how their chests look, no matter which procedure is used. Although most surgeries for pectus excavatum are performed around the growth spurt at puberty, many adults also have benefitted from pectus excavatum repair.
Temporarily freezing the nerves to block pain (cryoablation) can help with recovery and decrease postoperative pain for four to six weeks.
Doctors are currently studying therapies that use suction or magnets to help raise the depressed breastbone. These devices are best used in younger patients. As people age, the chest becomes more rigid, which limits chest wall movement.
Most adolescents just want to fit in and look like their peers. This can be exceptionally difficult for youngsters who have pectus excavatum. In some cases, counseling may be needed to help master coping skills. Online support groups and forums also are available, where you can talk with people who are facing the same types of problems.
If you or your child has pectus excavatum, you might first discuss the condition with your family doctor. He or she may refer you to a doctor who specializes in pediatric or thoracic surgery.
You may want to write a list that includes:
Your doctor may ask some of the following questions:
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