What is Pectus Excavatum?
Dr. Jaroszewski Explains Pectus Excavatum
Pectus excavatum is a condition in which a person's breastbone is sunken into his or her chest. The chest bows inward instead of outward. 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.
Adults with Pectus Excavatum May Have One or More of the Following Symptoms:
Progressive Loss of Endurance/ Exercise Intolerance
Shortness of Breath
Chest Pain or Pressure
Palpitations or Tachycardia
Indications for Surgical Repair Include:
Haller index of 3.2 or greater.
Cardiac Compression or shift
Frequent respiratory symptoms or exercise induced asthma
Significant body image disturbance
Abnormal cardiopulmonary tests
The Haller Index:
The Haller Index is measured at the deepest point of the defect. It's calculated by the width, from side to side (yellow line) divided by the height which is considered the distance between the sternum and the spine (red line). For accuracy of pectus excavatum measurements a CT scan is needed on inspiration and an expiration. See information on preoperative testing for further details.
Pectus can be corrected through surgery in a variety of ways. The most common of these is the minimally invasive procedure, often referred to as the Nuss Procedure. During this procedure the chest is elevated, lifting the sternum off of the heart, and two or more metal bars are inserted underneath the ribcage. These bars are left in for a recommended period of three years. Like braces reshape the mouth, these bars reshape the chest.