Pectus Excavatum

What is a pectus excavatum?

Pectus excavatum, also known as concave chest or funnel chest, 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. The condition is not always noticeable 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.

The level of severity ranges from mild to severe, but the condition does tend to get worse during growth spurts. 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, the effects on the heart and lungs are usually minor and typically only occur with extreme exercise.

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

What are the symptoms of pectus excavatum?

The symptoms of pectus excavatum depend 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 causes pectus excavatum?

There is no known cause for pectus excavatum. 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 suspicion that genes may play a significant role.

How we care for pectus excavatum

The Pectus and Chest Wall Treatment Program at Boston Children's Hospital evaluates and treats infants, children and young adults using state-of-the-art operative methods to improve the quality of life for each child entrusted to our care.

Our surgeons prefer to operate on children with pectus excavatum — if they operate at all — during the child's teen years. By then, children are through most of their growth spurts and have much lower risk of recurrence.

If your child develops scoliosis, the Spine Division at Boston Children’s is one of the nation’s foremost pediatric treatment and research centers.