Overview
Pectus excavatum (or funnel chest) is a common chest wall deformity where the breastbone (sternum) and ribs grow inward, creating a sunken or caved-in appearance, often noticeable at birth or during teenage growth spurts. While mild cases are cosmetic, severe cases can cause shortness of breath, chest pain, fatigue, and reduced exercise tolerance by affecting heart and lung function, leading to treatments like physical therapy, vacuum devices, or surgery (Nuss or Ravitch procedures) to correct the shape.
Causes
- Congenital: Present at birth, often due to excess growth of connective tissue joining ribs to the sternum, causing it to push inward.
- Growth Spurt: Can become more noticeable during teenage growth spurts.
- Genetics: May have a genetic link and can run in families.
Symptoms
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Physical:A noticeable dip in the chest; can be accompanied by rounded shoulders, flared lower ribs, and poor posture.
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Functional:In severe cases, it can compress the heart and lungs, leading to exercise intolerance, chest pain, fatigue, or breathing issues.
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Psychological:Can cause significant self-consciousness, leading individuals to avoid activities like swimming.
Diagnosis
- Visual examination of the chest.
- Tests like X-rays or CT scans to assess heart and lung impact.
Treatment Options
- Observation: Mild cases with no symptoms may need no treatment.
- Non-Surgical: Physiotherapy for posture, core strength, and breathing; Vacuum Bell device.
- Surgical (for severe cases or significant impact):
- Nuss Procedure: Minimally invasive, involves placing curved metal bars under the sternum to push it forward, removed later.
- Ravitch Procedure: Open surgery to reshape the sternum and cartilage, sometimes with a bar placement.
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