Pectus excavatum

What is a pectus excavatum?

Pectus excavatum is a deformity of your child's chest wall. The breastbone, or sternum, and some of the ribs grow abnormally, causing a depression in the middle of the chest.

When does pectus excavatum become apparent?

The condition is not always noticed at birth, but is often apparent by the time a child is 2 to 3. In some cases, the condition only appears as your child grows.

How serious is it?

The level of severity goes from extremely mild and almost unnoticeable to severe, but the condition does tend to get worse during growth spurts.

What kinds of health problems does a pectus excavatum cause?

While many children with pectus excavatum don’t require any treatment at all because their condition is so mild, a more severe case can press on the heart and lungs. However, these effects on the heart and lungs are usually minor and usually only with extreme exercise.

Also, approximately 15 percent of children who have pectus excavatum end up developing a condition called scoliosis (curvature of the spine).

Causes

What causes pectus excavatum?

We don't really know. Some studies investigating a genetic component are underway. Although the majority of cases don't involve a family history, there are many that do—enough to warrant the suspicion that genes may play a significant role.

If your child does develop scoliosis, the Spinal Program at Boston Children’s is one of the nation’s foremost pediatric treatment and research centers.

Signs and symptoms

What are the symptoms of pectus excavatum?

It depends on when the condition is diagnosed.

In infancy, symptoms of pectus excavatum can include:

• a hollow depression in the chest that may be broad and shallow, deep and narrow, or irregular
• more rapid breathing than normal

In older children, symptoms of pectus excavatum can include:

• shortness of breath upon exertion or exercise
• chest pain
• a lateral curvature of the spine, absence of the curve of the upper back, hooked shoulders and a broad thin chest

What is my child’s long-term outlook?

While most children with pectus excavatum don’t need any treatment at all, more severe cases can be surgically repaired, allowing your child to lead a normal, active life.