Pectus excavatum describes an abnormal formation of the rib cage that gives the chest a caved-in or sunken appearance.

Pectus excavatum is a congenital (present at birth) abnormality that can be mild or severe.

It is caused by too much growth of the connective tissue that joins the ribs to the breastbone. This causes the sternum to malform inward. The child typically has a depression in the center of the chest over the sternum, and this may appear quite deep.

If pectus excavatum is severe, it may affect the heart and lungs, making exercise difficult. Also, the appearance of the chest may cause psychological difficulty for the child.

Pectus excavatum may occur as the only abnormality, or together with other syndromes.

• Familial pectus excavatum
• Isolated defect
• Marfan syndrome
• Poland syndrome
• Rickets

Contact your health care provider if:

• You develop chest pain
• You develop trouble breathing
• You feel depressed or angry about your condition
• You notice decreased exercise tolerance
• You notice redness, swelling, or discharge from the area

Discuss pectus excavatum with your health care provider at each regular visit.

Your health care provider will take a medical history and perform a physical examination.

Medical history questions may include:

• When did you first notice this?
• Is it getting better, worse, or staying the same?
• Have any other family members had an unusual-shaped chest?
• What other symptoms do you have?

Physical examination:

An infant with pectus excavatum may have other symptoms and signs that, when taken together, define a specific syndrome or condition.

Diagnostic tests:

Laboratory studies to confirm the presence of a suspected disorder include:

• Chromosome studies
• Enzyme assays
• Metabolic studies
• X-rays

Pulmonary or cardiac function tests may be done to determine how severely the lungs and heart are affected.

Intervention:

This condition can be surgically repaired. Surgery is generally advised if you have other problems, such as trouble exercising. In addition, some people undergo surgery for cosmetic reasons. Your health care provider can help you make decisions about your therapy.

After seeing your health care provider:

If your health care provider made a diagnosis related to pectus excavatum, you may want to note that diagnosis in your personal medical record.