Disease: Pectus excavatum

Overview

Pectus excavatum is a condition in which a person's breastbone is sunken into his or her chest. In severe cases, pectus excavatum can look as if the center of the chest has been scooped out, leaving a deep dent.

While the sunken breastbone is often noticeable shortly after birth, the severity of pectus excavatum typically worsens during the adolescent growth spurt.

Also called funnel chest, pectus excavatum is more common in boys than in girls. Severe cases of pectus excavatum can eventually interfere with the function of the heart and lungs. But even mild cases of pectus excavatum can make children feel self-conscious about their appearance. Surgery can correct the deformity.

Pectus excavatum care at Mayo Clinic

Source: http://www.mayoclinic.com

Symptoms

For many people with pectus excavatum, their only sign or symptom is a slight indentation in their chests. In some people, the depth of the indentation worsens in early adolescence and can continue to worsen into adulthood.

In severe cases of pectus excavatum, the breastbone may compress the lungs and heart. Signs and symptoms may include:

  • Decreased exercise tolerance
  • Rapid heartbeat or heart palpitations
  • Recurrent respiratory infections
  • Wheezing or coughing
  • Chest pain
  • Heart murmur
  • Fatigue

Source: http://www.mayoclinic.com

Causes

While the exact cause of pectus excavatum is unknown, it may be an inherited condition because it sometimes runs in families.

Source: http://www.mayoclinic.com

Diagnosis

Pectus excavatum can usually be diagnosed simply by examining the chest. But your doctor may suggest several different types of tests to check for associated problems with the heart and lungs. These tests may include:

  • Chest X-ray. This test can visualize the dip in the breastbone and often shows the heart being displaced into the left side of the chest. X-rays are painless and take only a few minutes to complete.
  • Computerized tomography (CT). A CT scan may be used to help determine the severity of the pectus excavatum and whether the heart or lungs are being compressed. CT scans take many X-rays from a variety of angles to produce cross-sectional images of the body's internal structure.
  • Electrocardiogram. An electrocardiogram can show whether the heart's rhythm is normal or irregular, and if the electrical signals that control the heartbeat are timed properly. This test is painless and involves the placement of more than a dozen electrical leads, which are attached to the body with a sticky adhesive.
  • Echocardiogram. An echocardiogram is a sonogram of the heart. It can show real-time images of how well the heart and its valves are working. The images are produced by transmitting sound waves via a wand pressed against the chest.
  • Lung function tests. These types of tests measure the amount of air your lungs can hold and how quickly you can empty your lungs.
  • Exercise test. This test monitors how well your heart and lungs function while you exercise, usually on a bike or treadmill.

Source: http://www.mayoclinic.com

Complications

Severe cases of pectus excavatum can compress the heart and lungs or push the heart over to one side. Even mild cases of pectus excavatum can result in self-image problems.

Heart and lung problems

If the depth of the breastbone indentation is severe, it may reduce the amount of room the lungs have to expand. This compression can also squeeze the heart, pushing it into the left side of the chest and reducing its ability to pump efficiently.

Self-image problems

Children who have pectus excavatum also tend to have a hunched-forward posture, with flared ribs and shoulder blades. Many are so self-conscious about their appearance that they avoid activities, such as swimming, where the indentation in their chests is more difficult to camouflage with clothing.

Source: http://www.mayoclinic.com

Coping and support

Most adolescents just want to fit in and look like their peers. This can be exceptionally difficult for youngsters who have pectus excavatum. In some cases, counseling may be needed to help master coping skills. Online support groups and forums also are available, where you can talk with people who are facing the same types of problems.

Source: http://www.mayoclinic.com

Risk factors

Pectus excavatum is more common in boys than in girls. It also occurs more often in people who also have:

  • Marfan syndrome
  • Ehlers-Danlos syndrome
  • Osteogenesis imperfecta
  • Noonan syndrome
  • Turner syndrome

Source: http://www.mayoclinic.com

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