Pectus deformities of the chest wall are deformities of the rib cage, in which the breastbone, or sternum, (which supports and separates the left and right sides of the ribs) develops abnormally, and is sunken, or below normal height. The abnormality is usually present at birth or infancy, and can be mild or severe. If mild at birth, it often continues to grow worse as the child develops.
The cause is unknown. However, researchers believe that the physical condition is caused by the ribs growing faster than the expansion of the heart and lungs–organs that, as they develop, push the sternum outward. As a result, the sternum sinks inward.
If left untreated, pectus excavatum can cause compression of the heart and lungs.What are the symptoms of pectus deformities of the chest wall?
Most people with pectus excavatum do not have symptoms. A minority may have the following symptoms: fatigue, shortness of breath, chest pain and rapid heart rate.What are the risk factors for pectus deformities of the chest wall?
About 40 percent of people with pectus excavatum have one or more family members with the same condition. It occurs more often in men, appearing in one per every 300 to 400 white male births.What tests can I expect?
Your doctor and other specialists, including a thoracic surgeon and pulmonologist, will conduct a complete physical exam and comprehensive blood tests to confirm the diagnosis. They may also perform additional tests such as:
- Physical (stress) test
- Pulmonary (lung) function test
- Lab studies (blood work)
- Metabolic studies
- Chest X-ray
- CT scan of the chest
- Electrocardiogram (EKG)
- Echocardiogram (an ultrasound of the heart)
Treatment depends on the development of symptoms. Often there are no symptoms, so no treatment is necessary and most procedures are done for cosmetic reasons.
In young people, this can slow the development of the deformity and possibly reverse some of the sinking of the sternum.
MINIMALLY INVASIVE AND OPEN SURGERY
The Thoracic Surgery Division at Beth Israel offers patients a comprehensive assessment and evaluation on the need for surgical correction and is one of the few centers in Manhattan that offers modified Ravitch repair for this condition. The repair involves placing metal bar into the chest to correct the defect. Exact placement of the bar depends on the type of deformity.