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Pectus excavatum
Pectus excavatum
Ribcage
Ribcage

Pectus excavatum
Definition:
The descriptive term for an abnormal formation of the rib cage where the distance from the breastbone (sternum) to the backbone (vertebrae) is decreased, resulting in a caved-in or sunken chest appearance.

Alternative Names:
Funnel chest

Considerations:
Pectus excavatum is a congenital abnormality that can be mild or fairly marked. The child typically has a depression in the center of the chest over the sternum, and this may appear quite deep. It is caused by excessive growth of the costosternal cartilage (the connective tissue joining the ribs to the breastbone), with resulting inward deformity of the sternum.

If pectus excavatum is severe, it may affect the underlying organs (heart and lungs) leading to exercise intolerance or other problems. In addition, the cosmetic appearance of a pectus excavatum may pose a psychological difficulty.

Pectus excavatum may occur as the only abnormality, or in association with other syndromes.
Common Causes:
  • Isolated defect (i.e., not associated with other problems)
  • Familial pectus excavatum
  • Marfan's syndrome
  • Rickets
Call your health care provider if:
  • Trouble breathing develops
  • You note decreased exercise tolerance
  • Chest pain
  • Redness, swelling, or discharge from the area is noticed
  • Pectus excavatum should be discussed with your health care provider at each regular visit
What to expect at your health care provider's office:
The medical history will be obtained and a physical examination performed.

Medical history questions documenting pectus excavatum in detail may include:
  • When did you first notice this?
  • Is it getting better, worse, or staying the same?
  • Have any other family members had an unusual-shaped chest?
  • What other symptoms are present?
Physical examination:
An infant with pectus excavatum may have other symptoms and signs that, when taken together, define a specific syndrome or condition.

Diagnostic tests:
Laboratory studies such as chromosome studies, enzyme assays, X-rays, or metabolic studies may be ordered to confirm the presence of a suspected disorder.

Intervention:
This condition can be surgically repaired. Surgery is generally advised if associated problems such as difficulty with exercise develop. In addition, some people undergo surgery for cosmetic reasons. Your health care provider can assist you in making decisions about therapy.

After seeing your health care provider:
If a diagnosis was made by your health care provider related to pectus excavatum, you may want to note that diagnosis in your personal medical record.
Review Date: 1/21/2002
Reviewed By: Adam Ratner, M.D., Children's Hospital of Philadelphia, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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