Funnel chest deformity (Excavated chest): what is this, causes, symptoms, diagnostics, treatment, prevention

Excavated chest; Funnel chest; Cobbler’s chest; Sunken chest

Funnel chest deformity is a congenital (present at birth) chest deformity, which causes a sunken appearance of the sternum (sternum) and ribs. The condition is also known as "sunk chest" or "sunken chest". In severe cases, pectus excavatum can affect the functioning of the heart and lungs and cause difficulty breathing and other health problems..

Funnel-shaped deformity occurs in both men, and women, most common in children and adolescents. It is estimated, which is about one out of every 400 children have some degree of the disease. In some cases, the sternum may drop to such an extent, that compresses the heart and lungs, what affects a person's ability to breathe and causes chest pain. In more severe cases, it can lead to reduced strength and fitness..

Causes of pectus excavatum

The exact cause of pectus excavatum is not fully understood., but considered, that it is the result of abnormal cartilage growth, connects the ribs to the sternum. This abnormal growth causes the sternum to pull inward., which leads to a sunken appearance of the chest. Some studies suggest, that this condition can be inherited, although exact genetic factors are not yet known.

Symptoms of pectus excavatum

The symptoms of pectus excavatum are usually related to the severity of the condition.. In mild cases, this condition may not cause any noticeable symptoms., and many people with pectus excavatum are unaware, what they have. However, in severe cases, pectus excavatum can cause a range of symptoms., including:

• Breathlessness
• Chest pain
• Rapid breathing
• Fatigue
• Difficulty breathing while lying down
• Fast heartbeat

When to contact a healthcare professional

If you or your child experience any of the above symptoms, it is important to see a doctor for a proper examination. A doctor can help determine the cause of symptoms and prescribe appropriate treatment., to help deal with them. If you have severe pectus excavatum, especially important to see a doctor, as this condition can have a significant impact on the functioning of the heart and lungs.

Questions, that your doctor may ask

When you see your doctor for pectus excavation assessment, he will ask you a series of questions, which will help determine the severity of the condition and develop a treatment plan. Some of the questions, that your doctor may ask, include:

• When did you first notice sunken breasts?
• Have you experienced difficulty breathing or chest pain?
• Have you noticed any changes in your breathing while lying down??
• Have you noticed any changes in your heartbeat??
• Have you noticed any changes in your general health or energy levels?

Diagnosis of pectus excavatum

The diagnosis of pectus excavatum is usually based on a physical examination of the chest.. Your doctor may also order a chest x-ray, to determine the severity of the condition and identify any other underlying health problems. In some cases, your doctor may also order a CT scan or MRI., to better view the chest wall and rule out other health problems.

Treatment of pectus excavatum

Treatment for pectus excavatum depends on the severity of the condition and symptoms., which it evokes. Mild cases may not require treatment., and patients can be monitored for any changes in their condition. However, in more severe cases, treatment may be needed to prevent functional heart and lung problems..

Surgery is the most common treatment for pectus excavatum. The most common surgical procedure for pectus excavatum is called the Nuss procedure., which involves inserting a metal rod under the sternum, to push it out and fix the deformity. Then the beam is left for several years, until the cartilage heals and the sternum stabilizes in its new position. Another surgical option is the Ravic procedure., which includes removal of deformed cartilage and reshaping of the sternum and chest.

In addition to surgical treatment, there are also home treatment options., which can help manage the symptoms of pectus excavatum. Some of these options include:

• Physiotherapy: exercises and stretches can help improve breathing and reduce chest pain and discomfort.
• Chest braces: wearing a chest brace can help push the sternum out and prevent it from sinking further.
• Correct posture. Maintaining good posture can help improve breathing and reduce chest pain..

Prevention of pectus excavatum

Since pectus excavatum is a congenital disease, there is no reliable way to prevent its occurrence. Nonetheless, there are some steps, what parents can do, to reduce the risk of developing the disease in your child, including:

Promoting a healthy lifestyle. Encouraging children to live a healthy lifestyle through a balanced diet and regular exercise can help prevent a number of health problems., including pectus excavatum.

Smoking avoidance: secondhand smoke exposure may increase the risk of pectus excavatum, therefore it is important to avoid smoking and other forms of tobacco.

Conclusion

Funnel chest deformity is a congenital deformity of the chest., which can lead to hollowing of the sternum and ribs. In severe cases, it can affect the functioning of the heart and lungs., cause breathing difficulties and other health problems.

The diagnosis of pectus excavatum is usually based on physical examination and imaging studies., and treatment options include surgical procedures and home treatments, such as physiotherapy and chest orthoses.

Although there is no sure way to prevent pectus excavatum, parents can help reduce their child's risk of developing this disease, encouraging a healthy lifestyle and avoiding smoking.

If you or your child experience symptoms of pectus excavatum, it is important to see a doctor for a proper assessment and treatment plan.

Used sources and literature

Hello SR. Skeletal diseases influencing pulmonary function. In: Kliegman RM, St. Geme JW, Bloom NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 445.

Danielson PD, Colombani PM. Repair of excavated chest. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier Saunders; 2020:897-900.

Gottlieb LJ, Reid RR, Slidell MB. Pediatric chest and trunk defects. In: Rodriguez ED, Losee IS, Neligan PC, eds. Plastic Surgery: Volume 3: Craniofacial, Head and Neck Surgery and Pediatric Plastic Surgery. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 40.