PECTUS EXCAVATUM

What is Pectus Excavatum?

Pectus Excavatum occurs when the breastbone or sternum is pushed inward creating an indentation or depression in the middle of the chest producing a caved-in ‘sunken chest’ or ‘funnel chest’ appearance.  

Pectus Excavatum is present at birth but generally goes unnoticed in the early years of childhood. It is the most common congenital (there at birth) thoracic chest wall deformity, accounting for over 90% of all chest wall deformities. Many cases are found in the early teenage years as pectus excavatum tends to develop more prominently with growth spurts and after puberty. In some people, the depth of the indentation (Haller Index) worsens becoming more severe and pronounced in early adolescence and can continue to worsen into adulthood.

1 out of every 300 to 400 births of the population is affected with Pectus Excavatum. As concerns women, pectus excavatum can lead to breast deformity or asymmetry. The impact for all is mainly aesthetic and psychological, and very rarely functional.

Specialist Screening Healthcare Ireland’s PectusCheck service will identify and diagnose your pectus excavatum by offering both a consultant thoracic specialist opinion combined with specialist investigative diagnostic tests specifically tailored to Pectus Excavatum conditions.

Mild Pectus Excavatum

22 years old, Haller Index 2.9

Severe Symmetrical Pectus Excavatum

32 years old, Haller Index 4.3

Severe Symmetrical Pectus Excavatum

16 years old, Haller Index 6.3

Severe Asymmetric Pectus Excavatum with Asymmetric Rib Flare

28 years old, Haller Index 4.1

Know the Symptoms of Pectus Excavatum

For most individuals, they will have no symptoms of Pectus Excavatum and are asymptomatic apart from the visible chest deformity.

In general, individuals with Pectus Excavatum who do not have symptoms may never need treatment. Physical therapy such as breathing exercises and aerobic activity may be advised.

Cosmetic Symptoms of Pectus Excavatum

Visible chest deformity producing a caved-in ‘sunken chest’ or ‘funnel chest’ appearance.  Generally, a benign (not harmful) condition Pectus Excavatum in most cases is purely cosmetic in nature. Many patients seek cosmetic treatment options for Pectus Excavatum in order to correct the appearance of the chest.

Physical Symptoms of Pectus Excavatum

Physical symptoms are uncommon however, in severe cases of Pectus Excavatum, the following physical symptoms can be present.

  • Shortness of breath or trouble breathing, especially with physical exertion. In more severe cases of, Pectus Excavatum can compress the heart and lungs and affect breathing.
  • Coughing or wheezing.
  • Reduced exercise tolerance and stamina compared to peers.
  • Fatigue or extreme tiredness.
  • Chest pain.
  • Dizziness and syncope.
  • Heart palpitations (a rapid heartbeat), irregular heartbeat or heart murmur.
  • Frequent chest infections.
  • Spinal Issues also known as ‘Pectus induced spinal curvature’. Scoliosis is an irregular, sideways curving of the spine, which can sometimes be seen in patients with an asymmetric Pectus Excavatum.
  • Marfan syndrome, a connective tissue disorder that can be associated with Pectus Excavatum.
  • If clinically indicated, PectusCheck can organise a referral to a specialist Marfan’s clinic.
Psychological Symptoms of Pectus Excavatum

The following psychological symptoms can have a significant impact on activities of daily living. PectusCheck can organise a referral to a specialist psychologist if required.

  • Significant embarrassment from the appearance of the ches.t
  • Self-esteem/ poor self-body issues.
  • Clinical depression.

As a routine, PectusCheck informs all patients that NHS England will not routinely commission surgery for pectus deformity in accordance with the NHS surgery criteria for pectus deformity outlined in documents published on their website.

Specialist Screening Healthcare Ireland’s PectusCheck service will look for other causes for patients with pectus deformity that are symptomatic. Referral to other specialists can be coordinated if clinically indicated. 

Who is Most Likely to Have a Pectus Excavatum?

  • Individuals with a tall and slender build.
  • 4 times more common in males than females.
  • Family history of Pectus conditions.

There is an association with cartilage or connective tissue disorder. Pectus Excavatum can appear as a symptom of another disorder such as Marfan syndrome or sometimes alongside scoliosis (curvature of the spine).

Treatment Options for Pectus Excavatum

PectusCheck is able to offer the latest innovation diagnostic and new minimally non-invasive innovative treatment options for Pectus Excavatum.