Pectus Excavatum

Pectus excavatum, also known as sunken or funnel chest, is a congenital deformity of the anterior wall of the chest, in which several ribs and the sternum grow abnormally. This produces a caved-in or sunken appearance of the chest.

Causes and Risk Factors

Pectus excavatum is usually present at birth, but it may not be noticeable until puberty, when the deformity can become more pronounced due to rapid growth. The exact cause of pectus excavatum is unknown, but it is believed to result from an abnormal formation of the cartilage that connects the ribs to the sternum during fetal development.

Symptoms

Common symptoms of pectus excavatum include:

• A sunken or depressed area in the chest, which can be more noticeable when the person is lying down or engaging in physical activity
• Chest pain or discomfort, especially during deep breathing or exercise
• Shortness of breath or difficulty breathing, particularly during strenuous activities
• Fatigue or decreased endurance due to reduced lung capacity and cardiac output

Diagnosis

Pectus excavatum is typically diagnosed through a physical examination by a healthcare provider. The diagnosis may be confirmed with imaging tests, such as:

• Chest X-rays: To evaluate the shape of the chest and lungs
• Computed Tomography (CT) scans: To provide detailed images of the chest cavity and surrounding structures
• Magnetic Resonance Imaging (MRI): To assess the heart and lungs, as well as the deformity itself

Treatment Options

Treatment for pectus excavatum depends on the severity of the condition. Mild cases may not require treatment, while more severe cases can be treated with:

• Observation: Monitoring the condition to ensure it does not worsen over time
• Physical therapy: To improve posture and chest mobility
• Surgery: Such as the Nuss procedure or Ravitch procedure, which involve repairing the deformity by inserting a metal bar behind the sternum or removing cartilage and reshaping the ribs

Complications

If left untreated, pectus excavatum can lead to complications such as:

• Respiratory problems: Reduced lung capacity and increased risk of respiratory infections
• Cardiac issues: Decreased cardiac output and increased risk of heart problems
• Cosmetic concerns: Emotional distress due to the appearance of the chest

Prognosis

The prognosis for individuals with pectus excavatum varies depending on the severity of the condition. With proper treatment, most people can lead active and normal lives. However, in severe cases, the deformity can have a significant impact on quality of life.