Pectus Excavatum

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Pectus excavatum, commonly known as a sunken chest, is a congenital deformity of the chest wall that affects approximately 1 in 300-400 individuals. This condition is characterized by a depression or concave appearance of the sternum and rib cage, giving the chest a sunken or caved-in appearance. While pectus excavatum is primarily a cosmetic concern, it can also lead to various physical symptoms and complications. In this article, we will explore the common symptoms associated with pectus excavatum and discuss potential treatment options.

Sunken Chest: Aesthetic Concern or More?

At first glance, pectus excavatum may seem like a purely cosmetic issue. However, many individuals with this condition experience physical symptoms that can significantly impact their quality of life. One of the most common symptoms is shortness of breath. The abnormal shape of the chest can compress the lungs and limit their capacity, making it difficult to take deep breaths. This can lead to feelings of breathlessness, especially during physical activities or exertion.

Chest Pain and Heart Palpitations

Another symptom that individuals with pectus excavatum may experience is chest pain. The compression of the chest can put pressure on the heart and surrounding structures, leading to discomfort or pain in the chest area. Additionally, some individuals may also experience heart palpitations, which are abnormal heart rhythms that can cause a fluttering or pounding sensation in the chest.

Fatigue and Exercise Intolerance

Individuals with pectus excavatum often report feelings of fatigue and exercise intolerance. The restricted lung capacity and decreased cardiovascular efficiency can make physical activities more challenging, leading to fatigue and a reduced ability to engage in exercise. This can have a significant impact on overall fitness levels and may contribute to a sedentary lifestyle.

Treatment Options for Pectus Excavatum

While pectus excavatum cannot be completely cured, there are treatment options available to alleviate symptoms and improve the appearance of the chest. The most common treatment approach is surgery, specifically the Nuss procedure or the Ravitch procedure.

The Nuss Procedure

The Nuss procedure is a minimally invasive surgical technique that involves the placement of a curved metal bar beneath the sternum to reshape the chest. This procedure is typically performed on adolescents and young adults and has shown promising results in correcting the deformity and improving symptoms. The bar is usually left in place for a few years before being removed.

The Ravitch Procedure

The Ravitch procedure is a more traditional open surgery that involves removing a portion of the cartilage and ribs to reshape the chest. This procedure is often recommended for individuals with more severe cases of pectus excavatum. While it is a more invasive procedure, it can provide excellent results in terms of both aesthetics and symptom relief.

Lifestyle Modifications and Supportive Measures

In addition to surgical options, there are also lifestyle modifications and supportive measures that can help manage the symptoms of pectus excavatum. These include:

  • Regular exercise: Engaging in regular physical activity can help improve lung capacity and cardiovascular fitness. Low-impact exercises such as swimming or cycling are often recommended.
  • Posture correction: Maintaining good posture can help optimize lung function and reduce strain on the chest. Exercises and stretches that target the back and chest muscles can be beneficial.
  • Weight management: Maintaining a healthy weight can help reduce the strain on the chest and improve overall fitness levels.
  • Supportive garments: Wearing compression garments or braces can provide temporary relief by supporting the chest and improving posture.

It is important to note that the effectiveness of these lifestyle modifications may vary from person to person. Consulting with a healthcare professional is essential to determine the most appropriate treatment plan for individual cases.


Pectus excavatum, or a sunken chest, is a congenital deformity that can cause physical symptoms such as shortness of breath, chest pain, and fatigue. While it cannot be cured, there are treatment options available, including surgical procedures like the Nuss and Ravitch procedures. Additionally, lifestyle modifications and supportive measures can help manage symptoms and improve overall quality of life. If you or someone you know is affected by pectus excavatum, seeking medical advice is crucial to explore the most suitable treatment options.

Haroon Rashid, MD
Rate author
Urgent Care Center of Arlington, VA
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