Pectus Excavatum(Funnel Chest)Pronounced: Pek-tis X-ka-vay-tum
by
Pamela Jones, MA DefinitionPectus excavatum is an abnormal inward curve to the breastbone. It may be visible at birth. Growth through adolescence can make the indentation of the chest more apparent. It may continue until it has created a bowl-shape dent in the center of the chest. Severe forms can create extra pressure on the heart and lungs. This can lead to more serious health problems like shortness of breath and limited physical activities. CausesThe exact cause of pectus excavatum is not known. Some theories include:
Pectus excavatum may also be caused by conditions that affect connective tissue or chest structure, such as:
Risk FactorsRisk factors include:
Complications from pectus excavatum tend to increase with age due to bone growth and a decrease in the flexibility of the bones. SymptomsPectus excavatum is characterized by an indentation in the front of the chest wall. It may be mild or deep enough to form a bowl shape. If the indentation is severe enough to affect the heart or lungs you may also have:
A person with this condition may not have any symptoms during childhood. But as the person grows into an adolescent, he may have symptoms because of of a more pronounced indentation in the chest wall. DiagnosisYou will be asked about your symptoms and medical history. A physical exam will be done. Your doctor will often be able to diagnose pectus excavatum after a physical exam. Additional tests may be done to find out if your heart or lungs are affected. These tests may include:
TreatmentTalk with your doctor about the best treatment plan for you. Options include: SurgerySurgery may be considered for those who:
The ideal age for this type of surgery is 7-14 years. But surgery can also be successful in adults, as well. There are 2 main surgical options: Open Surgery (Ravitch Procedure)This surgery involves incisions in the front of the chest. The surgeon will be able to see your breastbone. Some cartilage will be removed from your breastbone and nearby ribs. The surgeon will place the breastbone in its proper position. A metal strut and mesh will be used to support the new position. The metal strut may come out in 6-12 months. Minimally Invasive Surgery (Nuss Procedure)Small incisions are made on either side of the chest. The surgeon will place a metal bar through the incisions and secure it under the breastbone. This bar will push the breastbone into a better position. This bar will remain in the chest for 2-3 years. This will allow the chest time to remodel itself. ExerciseYour doctor or physical therapist may recommend exercises or a rehabilitation program. Certain exercises and postural positions may decrease the appearance of mild pectus excavatum. PreventionThere is no known way to prevent this condition. RESOURCES:American Pediatric Surgical Association http://www.pediatricsurgerymd.org Healthy Children—American Academy of Pediatrics http://www.healthychildren.org CANADIAN RESOURCES:Canadian Association of General Surgeons http://www.cags-accg.ca/ Health Canada https://www.canada.ca References:Goretsky MJ, Kelly RE Jr, Croitoru D, Nuss D. Chest wall anomalies: pectus excavatum and pectus carinatum.
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2004;15(3):455-471. Jaroszewski D, Notrica D, McMahon L, Steidley E, Descahmps C. Current management of pectus excavatum: a review and update of therapy and treatment recommendations.
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2010;23(2):230. Mavanur A, Hight DW. Pectus excavatum and carinatum: new concepts in the correction of congenital chest wall deformities in the pediatric age group.
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Pectus excavatum. EBSCO DynaMed Plus website. Available at:
http://www.dynamed.com/topics/dmp~AN~T114889/Pectus-excavatum
. Updated February 19, 2016. Accessed November 13, 2017.
Pectus excavatum. McMaster Children’s Hospital website. Available at: ...(Click grey area to select URL) Accessed November 13, 2017. Last reviewed November 2018 by
EBSCO Medical Review Board
Warren A. Bodine, DO, CAQSM Last Updated: 7/13/2012 |
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