Pectus excavatum

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Complications

By Mayo Clinic staff

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Illustration showing breastbone depression Pectus excavatum

Severe cases of pectus excavatum can compress the lungs and push the heart over to one side. Even mild cases of pectus excavatum can result in self-image problems.

Heart and lung problems
If the depth of the breastbone indentation is severe, it may reduce the amount of room the lungs have to expand. This compression can also squeeze the heart, pushing it into the left side of the chest and reducing its ability to pump efficiently.

Self-image problems
Children who have pectus excavatum also tend to have a hunched-forward posture, with flared ribs and shoulder blades. Many are so self-conscious about their appearance that they avoid activities, such as swimming, where the indentation in their chests is more difficult to camouflage with clothing.

Preparing for your appointment Risk factors
References
  1. Boas SR. Skeletal diseases influencing pulmonary function. In: Kliegman RM. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/208746819-6/0/1608/0.html. Accessed Feb. 17, 2011.
  2. Tzelepis GE, et al. Pectus excavatum. In: Mason RJ, et al. Murray and Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/das/book/body/192068760-2/0/1288/0.html. Accessed Feb. 17, 2011.
  3. Mayer OH. Pectus excavatum: Etiology and evaluation. http://www.uptodate.com/home/index.html. Accessed Feb. 17, 2011.
  4. Jaroszewski DE, et al. Current management of pectus excavatum: A review and update of therapy and treatment recommendations. Journal of the American Board of Family Medicine. 2010;23:230.
  5. Mayer OH. Pectus excavatum: Treatment. http://www.uptodate.com/home/index.html. Accessed Feb. 17, 2011.
  6. What is Marfan syndrome? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/mar/mar_whatis.html. Accessed Feb. 18, 2011.
  7. What is scoliosis? National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Scoliosis/scoliosis_ff.asp. Accessed Feb. 18, 2011.
  8. What is mitral valve prolapse? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/mvp/mvp_whatis.html. Accessed Feb. 18, 2011.
  9. Sugarbaker DJ, et al. Chest wall deformities: Depression deformities (pectus excavatum). In: Townsend CM Jr, et al. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 18th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/208746819-6/0/1565/0.html. Accessed Feb. 22, 2011.
  10. Jaroszewski DE (expert opinion). Mayo Clinic, Scottsdale, Ariz. March 8, 2011.
  11. Kelly RE, et al. Twenty-one years of experience with minimally invasive repair of pectus excavatum by the Nuss procedure in 1215 patients. Annals of Surgery. 2010;252:1072.
  12. Nasr A, et al. Comparison of the Nuss and the Ravitch procedure for pectus excavatum repair: A meta-analysis. Journal of Pediatric Surgery. 2010;45:880.
  13. Coelho MS, et al. Pectus excavatum surgery: Sternochondroplasty versus Nuss procedure. Annals of Thoracic Surgery. 2009;88:1773.
DS01136 April 15, 2011

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