Pectus Excavatum

Pectus excavatum is a quite frequent congenital malformation of the chest. It may cause many problems and complications, but it can be solved by means of modern medicine.


The exact cause of condition is unknown; there is certainly a genetic precondition. The malformation is more typical for men than women. Higher incidence of pectus excavatum is reported in Marfan syndrome.


The condition manifests with deformation of sternum and ribs. The sternum is inverted towards the chest cavity and it can be even rotated. The malformation looks like a unilateral chest depression at the site of the pectoral muscle. Women also suffer from deformation of the breast at the affected side. Severe cases of pectus excavatum may include various disorders of organs located in the chest such as the heart and lungs. People with the disorder get easily tired and may suffer from exertional shortness of breath, especially when there is present a decrease of cardiac output with possible symptoms of heart failure. Psychological problems are related to cosmetic consequences of the malformation.


The diagnosis is confirmed by pediatricians and surgeons. The extent of the malformation can be evaluated by various imaging methods such as the chest X-ray or computed tomography. The patients should have examined heat and lung function by using echocardiography, spirometry and other functional lung tests.


The therapeutic approach depends on the severity of the defect. Some very mild cases may be treated conservatively with regular exercise and proper strengthening of the chest muscles. More serious cases are treated surgically to correct the defect and restore normal local anatomical relations. The intervention is usually done with collaboration with plastic surgeons including breast reconstruction procedures in women. The affected breast may be reconstructed by using an implant.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources