Symptoms and causes

Symptoms

For many people with pectus excavatum, their only sign or symptom is a slight indentation in their chests. In some people, the depth of the indentation worsens in early adolescence and can continue to worsen into adulthood.

In severe cases of pectus excavatum, the breastbone may compress the lungs and heart. Signs and symptoms may include:

  • Decreased exercise tolerance
  • Rapid heartbeat or heart palpitations
  • Recurrent respiratory infections
  • Wheezing or coughing
  • Chest pain
  • Heart murmur
  • Fatigue

Causes

While the exact cause of pectus excavatum is unknown, it may be an inherited condition because it sometimes runs in families.

Risk factors

Pectus excavatum is more common in boys than in girls. It also occurs more often in people who also have:

  • Marfan syndrome
  • Ehlers-Danlos syndrome
  • Osteogenesis imperfecta
  • Noonan syndrome
  • Turner syndrome

Complications

Severe cases of pectus excavatum can compress the heart and lungs or push the heart over to one side. Even mild cases of pectus excavatum can result in self-image problems.

Heart and lung problems

If the depth of the breastbone indentation is severe, it may reduce the amount of room the lungs have to expand. This compression can also squeeze the heart, pushing it into the left side of the chest and reducing its ability to pump efficiently.

Self-image problems

Children who have pectus excavatum also tend to have a hunched-forward posture, with flared ribs and shoulder blades. Many are so self-conscious about their appearance that they avoid activities, such as swimming, where the indentation in their chests is more difficult to camouflage with clothing.

May 02, 2017
References
  1. Kliegman RM, et al. Skeletal diseases influencing pulmonary function. In: Nelson Textbook of Pediatrics. 20th ed. Philadelphia, Pa.: Elsevier; 2016. http://www.clinicalkey.com. Accessed Jan. 18, 2017.
  2. Mayer OH. Pectus excavatum: Etiology and evaluation. http://www.uptodate.com/home. Accessed Jan. 18, 2017.
  3. AskMayoExpert. Pectus excavatum. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.
  4. Holcomb GW, et al. Congenital chest wall deformities. In: Ashcraft's Pediatric Surgery. 6th ed. Philadelphia, Pa.: Elsevier; 2014. http://www.clinicalkey.com. Accessed Jan. 18, 2017.
  5. Mayer OH. Pectus excavatum: Treatment. http://www.uptodate.com/home. Accessed Jan. 18, 2017.
  6. Jaroszewski DE, et al. Success of minimally invasive pectus excavatum procedures (modified Nuss) in adult patients. Annals of Thoracic Surgery. 2016;102:993.
  7. Brown AY. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Jan. 30, 2017.
  8. Jaroszewski DE (expert opinion). Mayo Clinic, Phoenix/Scottsdale, Ariz. Feb. 12, 2017.