Description

Pectus excavatum is a condition in which the breastbone is sunken into the chest. The sternum sunk, and can often be seen shortly after birth. If the sternum is sinking much over the course of time, the center of the chest may look that has been taken out. This change leaves a deep dent or dip. But many people with the condition only have a slight dip in the breastbone.

This condition is also known as funnel chest. But it can affect much more than the appearance of the chest. It can also cause symptoms such as shortness of breath, chest pain, and a fast heartbeat, palpitations or pounding heart. Symptoms tend to be worse during the adolescence stage of growth.

The exact cause of pectus excavatum is not clear. When the disease is severe, can affect how well the heart and lungs with the time. But even mild pectus excavatum, which causes a slight dip in the breastbone can make children feel self-conscious about their bodies.

The surgery to repair pectus excavatum can improve symptoms and the appearance of the chest. But the surgery is not appropriate for all people with the condition. Other treatment options may include physical therapy, and medical devices.

Symptoms

For many people with pectus excavatum, the only symptom is a slight dip in their breasts. In some children, the sauce makes it deeper during puberty. You may continue to receive more deep in adulthood.

In people with pectus excavatum, the sternum can compress the lungs and heart. Symptoms may include:

  • A fast heartbeat, palpitations or pounding heart.
  • Pain in the chest.
  • The loss of resistance that gets worse with time.
  • Shortness of breath or extreme fatigue during physical activity.
  • A high-pitched whistling sound made while breathing that is caused by the exercise.
  • Fainting, or dizziness.
  • Frequent infections of the upper respiratory tract.
  • The stress and worry about how the breast looks.

When to see a doctor

Consult a health professional if you or your child has any of the symptoms of pectus excavatum. This is key if the symptoms get worse, or if your chest keeps getting more sunken.

Causes

The exact cause of pectus excavatum is not known. Some experts believe that this has to do with the connective tissue called cartilage. The cartilage that connects the sternum, the ribs can develop in an irregular way. Genes may play a role in this process.

Risk factors

Pectus excavatum risk factors may include the following:

  • Having a family history of pectus excavatum.
  • Living with a connective tissue disease such as Marfan syndrome, Ehlers-Danlos syndrome, down syndrome, or osteogenesis imperfecta.
  • Have a genetic condition such as Noonan syndrome or Turner syndrome.

Complications

Sometimes, pectus excavatum can lead to serious health problems called complications. Complications can affect the heart, lungs, and mental health.

The heart and lung problems

If the depth of the dent in the sternum is severe, the lungs may not have enough space to fully expand. This can also squeeze the heart. The heart may be pushed to the left and can't pump blood as well as it should. This can cause symptoms such as less able to exercise, shortness of breath, rapid heartbeat, chest pain or pressure.

The self-image of the concerns

Many people who have pectus excavatum also tend to have a hunched-forward posture. Their lower ribs can appear and their rounded shoulders. Many feel stress about how their bodies. Can stay away from activities in which the chest can be seen, such as swimming. You could also use the clothes that you hide from the immersion in the chest.

Diagnosis

The diagnosis involves the steps that a healthcare provider needs to find out if you or your child has pectus excavatum. The health professional begins by making an examination of the chest. This may be enough to diagnose the condition. Other tests may detect health problems associated with pectus excavatum that affect the heart and lungs. These tests may include:

  • X-ray of the chest. This test can make the images of the dip in the breastbone. Often shows the heart being pushed into the left side of the chest. X-rays take only a few minutes to do so.
  • Computed tomography or magnetic resonance imaging. Each of these tests can help determine how severe pectus excavatum is. It can also show if the heart or lungs are compressed. The computed tomography and magnetic resonance imaging taking a lot of pictures from different angles to produce detailed images of organs and tissues in the body.
  • The electrocardiogram. An ekg can show if the heart rhythm is regular or not. It can also show if the electrical signals that control the heartbeat are programmed correctly. To make the test, a health care professional places sticky patches called electrodes on your chest. The cables connect the patches to a computer that prints or displays the results.
  • The echocardiogram. An echocardiogram can show real-time images of how well the heart and the heart valves are working. To make the test, a health care professional press a wand against your chest. The wand emits sound waves to obtain images of the heart. An echocardiogram also shows if the chest wall may be affecting the function of the heart and the flow of blood through the heart.
  • Tests of pulmonary function. These types of tests to measure the amount of air that the lungs can hold. They can also measure the speed of the lungs to expel the air.
  • The exercise of the function test. This test tracks how well the heart and lungs during exercise, usually on a bike or treadmill.

Treatment

Pectus excavatum treatments include physical therapy, medical devices and surgery. The surgery is mainly for people who have moderate to severe symptoms. People who have mild symptoms may improve with other treatments.

Some treatments are only intended to improve the way in which the chest is seen. For example, dermal fillers or silicone implants can help to complete the sunken part of the chest.

Therapies

Treatments that do not require surgery can help some people with a mild degree of pectus excavatum. These include the following:

  • The physical therapy. Some physiotherapy exercises can improve posture and increase in the degree in which the chest can be expanded.
  • Sternal suction. This is a treatment for children and young teenagers, it involves the placement of a cup or a bell-shaped device in the sternum. The device uses suction to gently pull the sternum forward. The device should be used by one or more hours per day during 12 to 15 months.

Surgery or other procedures

The surgery to repair pectus excavatum can relieve symptoms and improve the way in which the chest is seen. The surgery tends to be a treatment option for adolescents and young adults. Surgery may be appropriate for some older people also.

Two types of surgeries can repair pectus excavatum:

  • Procedure Nuss. This is the most common type of surgery. It is minimally invasive, that is to say, through the small cuts. In general, the surgeon makes small incisions on each side of the chest. The surgeon places the tools with long handles and a small camera through the courts. Then, the surgeon places a curved metal bar under the sternum sunk. The bar is rotated to raise the sternum in a typical position. Often, more than one bar is used. The bars are removed, after some two or three years.
  • The technique of Ravitch. This age of surgery is performed much less frequently than the procedure of Nuss. With the technique of Ravitch, the surgeon makes a much larger cut down the center of the chest. The surgeon removes the deformation of the cartilage that joins the ribs to the lower part of the breastbone. Then, the surgeon corrects the sternum in a position to regulate surgical hardware. The hardware may include a strut of metal or mesh supports. These brackets are removed after a year or more.

The majority of people who undergo surgery to correct pectus excavatum are happy with the change in the way your breasts look. The studies found that to be true, it does not matter which of the two surgeries that people had.

Surgeons have many ways to help control the pain of the surgery. During the surgery, you can freeze the nerves to block the pain after the surgery. This is called cryoablation, and can help with the recovery. The pain relief effects may last for weeks.

Other treatments that aim to improve the appearance of the chest. These are so-called cosmetic treatments. Are primarily for people who have mild pectus excavatum without significant symptoms. A health care provider may place a silicone implant in the chest to fill in the sunken area. Or shots of certain dermal fillers can help to fill in the area.

Coping and support

The majority of children and teens just want to fit in and watch as their peers. This can be very hard for young people who have pectus excavatum. Counseling may help some children and teens feel better about themselves. Online support groups and forums are also available. These can help connect children and young people with other young people who have pectus excavatum.

Preparing for your appointment

If you or your child has pectus excavatum, you could first talk about the condition with the family health care professional. Then you may be referred to a physician who does pediatric or chest surgery.

What you can do

You can write a list that includes:

  • Detailed descriptions of your symptoms or your child's symptoms.
  • Information about past health problems.
  • Information about common health conditions in your family.
  • All medications and supplements that you or your child need.
  • Questions you want to ask the health care team, including what treatments are available.

What to expect from your doctor

Your health care professional may do some of the following questions:

  • When did these symptoms start?
  • They have become worse recently?
  • Have someone in your family has had pectus excavatum?
Symptoms and treatment of Pectus excavatum