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Learning About Pectus (Pectus Excavatum)

A normal chest compared to a sunken chest (pectus excavatum)

What is it?

Pectus excavatum is a problem with the cartilage that connects the bones of the chest. It looks like a dent in the centre of the chest. It also may be called pectus, funnel chest, or sunken chest. Pectus by itself isn't dangerous.

What causes it?

The cause of pectus isn't known. It may be passed down in families. Some people who have it have other genetic conditions too.

What can you expect when you have it?

Some people with pectus are born with it or develop it as teens. It may not be noticed until later, especially at puberty during growth spurts. If pectus is mild, it usually doesn't cause problems. If it's severe, you may have problems with your heart and lungs.

What are the symptoms?

Many people with mild pectus have no symptoms. Some people with more severe pectus may have trouble breathing, especially during exercise. Or they may have chest pain.

How is it diagnosed?

Your doctor will ask you questions about your health and do a physical examination. He or she may do tests to see how serious the pectus is or to check for problems with your heart and lungs. You may also have tests if you're thinking about having surgery. These tests may include:

  • Lung function tests to check how well your lungs work. They may also be called pulmonary function tests, or PFTs.
  • MRI, X-rays, or CT scans.
  • An exercise or stress test to check your lungs.
  • An electrocardiogram (ECG or EKG) to see if you have an abnormal heart rhythm.
  • An echocardiogram (echo) to measure your heart function.

How is it treated?

Most cases of pectus don't need treatment. But in severe cases, surgery may be done. Options include the:

Ravitch procedure.

This is open-chest surgery in which chest cartilage that is the wrong shape is removed. Then the breastbone (sternum) is moved to the right position.

Nuss procedure.

Small cuts (incisions) are made on both sides of the chest. The doctor inserts one or more curved bars behind the breastbone and attaches them to the ribs. The breastbone is held in place for 2 to 4 years. Then the bars are removed.

If you need surgery, your doctor can talk with you about the procedures and their risks.

Your doctor may recommend exercise to help improve your posture and expand your chest. But exercise won't cure pectus.

Some people with pectus may feel embarrassed about how their chest looks. They may have low self-esteem or even depression. If this happens, counselling may help.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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