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Pectus Excavatum

Pectus Excavatum is the most common congenital chest cavity deformity and is characterised by a concave depression of the sternum, better known as: sunken chest or funnel chest.  Undoubtedly, the defining feature of Pectus Excavatum is the sunken appearance of the sternum.

It is a progressive condition which can be visible from birth, but typically becomes more obvious over the years.  It occurs in 1 in every 1,000 births, predominantly in males (by a ratio of 3:1). It has been noted that this deformity is hereditary in 35% to 45% of cases.

Pectus Excavatum may present in varying degrees. There are patients with a mild deformity, almost asymptomatic though with aesthetic implications, and others who present with a moderate or severe deformity who develop serious physical problems and socio-psychological disorders.

Pectus Excavatum may also be linked to Marfan*or Poland** syndromes.

Paediatricians or GPs tends to be the first professionals consulted by patients looking to obtain information about Pectus Excavatum. If the patient is under the age of six and asymptomatic, there is no need for either additional tests or surgery. If older, then an annual check-up is important to monitor whether or not the defect is progressive. If the defect worsens or symptoms related to Pectus Excavatum present, the patient needs to be assessed by a paediatric or thoracic surgeon to receive the best treatment for their specific Pectus Excavatum.

 


* Marfan Syndrome: This syndrome is characterised by a connective tissue disorder which affects the skeletal and cardiovascular systems.  In most cases, it is hereditary and passes from fathers to sons; however, up to 30% of patients have no family history of the condition.

** Poland Syndrome: This is a congenital disorder which is consistent in the partial or total absence of the pectoralis major muscle and costal or rib cartilage and may be linked to other pectoral, cervical, intra-thoracic or even brachial abnormalities.