Pectus excavatum

What is pectus excavatum?

This is a congenital deformity of the rib cage in which the breastbone is sunken into the chest. If pectus excavatum is not treated, it can cause compression (pressure) of the lungs and heart.

Image of a man's torso, which displays a sunken breastbone which is an indicator of pectus excavatum

Is pectus excavatum serious?

Severe cases of pectus excavatum are serious because they eventually interfere with heart and lung function. It's important to see a specialist in order to look at treatment solutions for this, including surgery. 

What are the symptoms?

The main symptoms of pectus excavatum include:

  • Difficulty breathing
  • Chest pain
  • Resistance to exercise
  • Wheezing or coughing
  • Fatigue

What causes pectus excavatum?

Researchers believe that pectus excavatum is due to an irregular growth of connective tissue (cartilage) that connects the ribs to the breastbone. This irregular growth causes the breastbone to move inwards.

Can it be prevented?

Unfortunately, pectus excavatum cannot be prevented, but the good news is that it can be treated.

Can pectum excavatum get worse?

Pectum excavatum can get worse in children as they age. It often gets worse around the time puberty begins, between 12 to 14 years. 

Symptoms also may start to present once this occurs. 

What does treatment involve?

If pectus excavatum causes problems in the heart or lungs, doctors may recommend surgery. The aim is to improve breathing, function, and heart position. There are several surgical procedures for this purpose:

The Nuss procedure

This is a non-invasive technique. A small incision is made to insert a camera that allows the surgeon to see inside the chest. Then, through two other incisions on each side of the chest, a curved steel bar is inserted under the breastbone to reverse the depression. It is not visible from the outside and remains there for two to three years before eventually being removed.

The Ravitch procedure

This is performed through an incision made in the middle of the chest to remove the cartilage. Stainless steel bars are then put in place to support the sternum and the corresponding ribs are connected. This allows the sternum to be lifted. These will later be removed in another operation.

It is also possible to correct pectus excavatum without surgery, with vacuum bell therapy. However, this is very uncomfortable and requires perseverance and years of application to correct the problem.

 07-05-2023
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Pectus excavatum

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Mr Shyamsunder Kolvekar - Cardiothoracic surgery

Created on: 11-13-2012

Updated on: 07-05-2023

Edited by: Karolyn Judge

What is pectus excavatum?

This is a congenital deformity of the rib cage in which the breastbone is sunken into the chest. If pectus excavatum is not treated, it can cause compression (pressure) of the lungs and heart.

Image of a man's torso, which displays a sunken breastbone which is an indicator of pectus excavatum

Is pectus excavatum serious?

Severe cases of pectus excavatum are serious because they eventually interfere with heart and lung function. It's important to see a specialist in order to look at treatment solutions for this, including surgery. 

What are the symptoms?

The main symptoms of pectus excavatum include:

  • Difficulty breathing
  • Chest pain
  • Resistance to exercise
  • Wheezing or coughing
  • Fatigue

What causes pectus excavatum?

Researchers believe that pectus excavatum is due to an irregular growth of connective tissue (cartilage) that connects the ribs to the breastbone. This irregular growth causes the breastbone to move inwards.

Can it be prevented?

Unfortunately, pectus excavatum cannot be prevented, but the good news is that it can be treated.

Can pectum excavatum get worse?

Pectum excavatum can get worse in children as they age. It often gets worse around the time puberty begins, between 12 to 14 years. 

Symptoms also may start to present once this occurs. 

What does treatment involve?

If pectus excavatum causes problems in the heart or lungs, doctors may recommend surgery. The aim is to improve breathing, function, and heart position. There are several surgical procedures for this purpose:

The Nuss procedure

This is a non-invasive technique. A small incision is made to insert a camera that allows the surgeon to see inside the chest. Then, through two other incisions on each side of the chest, a curved steel bar is inserted under the breastbone to reverse the depression. It is not visible from the outside and remains there for two to three years before eventually being removed.

The Ravitch procedure

This is performed through an incision made in the middle of the chest to remove the cartilage. Stainless steel bars are then put in place to support the sternum and the corresponding ribs are connected. This allows the sternum to be lifted. These will later be removed in another operation.

It is also possible to correct pectus excavatum without surgery, with vacuum bell therapy. However, this is very uncomfortable and requires perseverance and years of application to correct the problem.

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Cardiothoracic surgery

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