The cause of this malformation has not yet been definitively determined. However, there is evidence suggesting that
- there is a weakness in the anterior chest wall or
- mechanical factors play a role in its development.
Furthermore, up to 40 percent of cases show a family history of the condition. Therefore, it is assumed that genetic factors also contribute to the development of pectus excavatum.
Pectus excavatum in a man © jupiter8 | AdobeStock
In addition, this chest deformity occurs more frequently in association with various syndromes, such as
- Marfan syndrome,
- Poland syndrome, and
- fetal alcohol syndrome.
Pectus excavatum is usually recognizable immediately after birth. The condition becomes more pronounced as the body continues to grow. Since the chest wall is still elastic, the heart and lungs can adapt to the anatomical situation within the thorax. For this reason, children and adolescents often do not experience any physical symptoms.
However, as the child gets older and the degree of retraction increases, physical symptoms may develop. For example, the misalignment of the ribs can affect the spine and lead to poor posture.
The shoulders are then often tilted forward, the abdomen protrudes, and the spine is curved backward (kyphosis). As a result, the intervertebral discs are subjected to greater stress, leading to back pain.
If the poor posture causes increased pressure on the stomach, heartburn may occur more frequently. Occasionally, funnel chest may also be accompanied by symptoms such as
- shortness of breath,
- palpitations, and
- rapid fatigue
. However, lung function and cardiac examinations rarely reveal any pathological findings.
Since children and adolescents often suffer from this deformity, psychological issues may develop. For example, some may reject their bodies, avoid sports, shy away from going to the pool, and withdraw from their social circles.
If physical symptoms develop over time or if those affected suffer significantly from psychosocial consequences, surgery is an option. Two methods have proven effective. You can learn more about these and an alternative treatment using a suction bell under “Funnel Chest Surgery.”
Pectus excavatum is the most common congenital deformity of the chest and can be detected as early as childhood and adolescence. The severity of pectus excavatum ranges from a mild deformation of the chest to a severely sunken chest wall shaped like a funnel. The exact cause of pectus excavatum is not fully understood, but the cartilaginous connections between the sternum and the ribs play an important role. In particular, the cartilaginous connections between the sternum and the right and left ribs may be altered, causing the sternum and four to five ribs to pull inward. Pectus excavatum is a condition that can occur symmetrically or asymmetrically and affects girls more frequently than boys.
If pectus excavatum is suspected, a thorough diagnostic evaluation is conducted to determine the specific type of pectus excavatum and any associated physical symptoms. A severe case of pectus excavatum can affect organs such as the heart and lungs and lead to shortness of breath or rapid exhaustion during physical activity. Psychological stress also often plays a major role in children and adolescents. Treatment for funnel chest depends on the severity and includes physical therapy, exercises to strengthen the back, and targeted measures to strengthen the back and improve posture.
If the funnel chest is more severe, surgical correction may be necessary. A particularly well-known procedure is the Nuss procedure, developed by Donald Nuss. In this procedure, a metal bar is inserted behind the sternum to gradually correct the deformity. Causes and risk factors should always be assessed on an individual basis to ensure appropriate treatment of pectus excavatum.
What is pectus excavatum?
Pectus excavatum is a congenital deformity of the chest wall in which the sternum is pulled inward. This deformity of the chest is also known as sunken chest and can occur symmetrically or asymmetrically.
What symptoms does pectus excavatum cause?
Many people affected experience only mild symptoms. However, in severe cases of pectus excavatum, shortness of breath, back pain, poor posture, or physical discomfort during sports may occur. Organs such as the heart and lungs may also be affected.
How is funnel chest treated?
Treatment for funnel chest depends on the severity of the condition. Mild forms are often treated with physical therapy or exercises to strengthen the back. For more severe indentations, a suction cup or Nuss procedure may be considered.
When is surgery necessary?
Surgery is usually recommended when the funnel chest is severe or causes symptoms. In the Nuss procedure for correcting funnel chest, a metal bar is inserted behind the sternum to lift the chest.
Can pectus excavatum be psychologically distressing?
Yes, children and adolescents in particular often find the visible deformity psychologically distressing. Boys are affected more often than girls. In addition to the physical impairment, posture can also be affected by pectus excavatum.
