Pectus excavatum is a structural chest wall deformity where the breastbone, or sternum, appears sunken into the chest. This condition is also known as “funnel chest” or “sunken chest” due to its characteristic inward indentation. It can be present from birth or develop later, often becoming more noticeable during adolescent growth spurts.
Visual Indicators
The most apparent characteristic of pectus excavatum is the visible chest indentation. This depression typically affects the sternum’s lower end and may involve surrounding ribs. The indentation’s shape can range from a broad, saucer-like concavity to a more focused, cup-shaped or trench-like depression. Its depth can be mild, almost unnoticeable, or severe, appearing as if the chest center has been significantly scooped out.
The deformity might be symmetrical, with an even dip in the chest’s middle, or asymmetrical, with the indentation more pronounced on one side, often causing sternum rotation. Individuals with pectus excavatum may also exhibit flared lower ribs, which protrude outward. Poor posture, characterized by slumped shoulders and a forward-curved upper spine, can sometimes accompany the condition, further highlighting the chest’s appearance. Visual signs often become more prominent during activities that expose the chest or during periods of rapid growth.
Associated Physical Sensations
Beyond visual manifestations, pectus excavatum can lead to physical sensations, particularly in more pronounced cases. Individuals may experience shortness of breath, especially during physical exertion, as the sunken breastbone can reduce space for lung expansion. Chest pain or discomfort is another common complaint, often originating from the musculoskeletal system or internal structure compression.
Heart-related symptoms can also arise, including palpitations, a rapid heartbeat, or an irregular rhythm. This occurs because the inward sternum can sometimes displace or compress the heart, impacting its ability to pump blood efficiently. Reduced stamina and fatigue are common, making exercise challenging. Less common but possible sensations include dizziness or, in severe instances, fainting.
When to Consult a Professional
Recognizing potential pectus excavatum signs through self-assessment is a starting point, but a medical evaluation is necessary for accurate diagnosis. Seek medical advice if you notice any described visual indicators in yourself or a child. This is particularly important if the indentation appears to be deepening or if you observe any associated physical sensations.
Early evaluation is beneficial, especially for children and adolescents, as the condition can worsen during growth spurts. Consulting a healthcare professional, such as a primary care doctor or a pediatrician, is the appropriate next step. They can provide an initial assessment and determine if further specialized evaluation is needed. Addressing concerns promptly allows for monitoring the condition’s progression and its potential impact on heart and lung function.
Medical Confirmation Procedures
Upon consultation, a medical professional typically begins diagnosis with a physical examination, assessing the chest’s shape and indentation depth. They will also discuss your medical history and any symptoms. To confirm diagnosis and evaluate severity, imaging tests are used. A chest X-ray can provide initial images of the breastbone’s dip and show any heart displacement.
A computed tomography (CT) scan is often performed, offering detailed three-dimensional images of the chest cavity. This scan is crucial for precisely measuring the Haller Index, a ratio calculated from the chest’s transverse diameter and the shortest distance between the sternum and the spine. A normal Haller Index is typically around 2.5, while a value exceeding 3.25 is generally considered severe. Magnetic resonance imaging (MRI) can also be used, particularly to avoid radiation exposure in younger patients, providing similar detailed views. Additional tests, such as an echocardiogram to assess heart function or pulmonary function tests to measure lung capacity, may be conducted, especially if symptoms like shortness of breath or chest pain are present.