Pectus Excavatum

Causes of Pectus Excavatum

The exact cause of pectus excavatum is not well understood. However, researchers believe that genetic factors play a key role in the development of this condition, as it tends to run in families. Here are some factors that may contribute to the development of pectus excavatum:

Symptoms of Pectus Excavatum

The symptoms of pectus excavatum can vary depending on the severity of the condition. Many individuals with mild cases may experience no symptoms beyond the cosmetic appearance of a sunken chest. However, more severe cases may lead to physical discomfort and complications. Here are some common symptoms:

• Cosmetic Concerns : In most cases, the primary concern is the physical appearance of the chest, which can lead to self-esteem and body image issues, particularly during adolescence.
• Shortness of Breath : As the sternum presses on the lungs and reduces the available space, individuals may experience difficulty breathing, especially during physical exertion or exercise.
• Chest Pain : Some people with pectus excavatum experience chest pain due to the abnormal pressure on the ribs, sternum, and surrounding tissues.
• Reduced Exercise Tolerance : Individuals with more severe cases may find that they tire easily during physical activities due to restricted lung capacity and diminished cardiovascular function.
• Heart Palpitations : The inward depression of the sternum can sometimes compress the heart, leading to irregular heartbeats or palpitations. In severe cases, the heart’s ability to pump blood efficiently may be affected.
• Respiratory Infections : In rare cases, individuals with pectus excavatum may experience frequent respiratory infections due to compromised lung function.

Diagnosis of Pectus Excavatum

Diagnosis of pectus excavatum is typically straightforward and based on a physical examination. However, doctors may perform additional tests to assess the severity of the condition and determine whether it is affecting the function of the heart and lungs. Here’s how pectus excavatum is diagnosed:

• Physical Examination : The doctor will visually examine the chest to observe the depth and extent of the depression. In mild cases, this may be the only diagnostic method required.
• Imaging Tests : X-rays, CT scans, and MRI scans are commonly used to measure the depth of the sternum’s depression and assess any potential impact on internal organs. A CT scan can also be used to calculate the "Haller Index," which measures the ratio of the chest’s width to its depth. A higher Haller Index indicates a more severe deformity.
• Pulmonary Function Tests : These tests assess lung capacity and the ability to move air in and out of the lungs. Individuals with severe pectus excavatum may have reduced lung function, particularly during exercise.
• Echocardiogram : This ultrasound test is used to evaluate the function of the heart and determine if the deformity is compressing the heart or affecting blood flow. It can also detect any associated heart abnormalities.
• Electrocardiogram (ECG) : An ECG may be performed to check for any abnormal heart rhythms or issues related to heart function that may be caused by the compression of the chest.

Living with Pectus Excavatum

For those with mild pectus excavatum, the condition may not significantly impact daily life. However, in moderate to severe cases, it’s essential to monitor any symptoms related to heart or lung function. Regular check-ups and following a healthy lifestyle can help individuals manage their condition more effectively. Physical activity, such as cardiovascular exercises and strength training, can help improve lung capacity and posture, although strenuous activities should be done under medical guidance if there are concerns about heart function.

There is no way to prevent a collapsed lung, although the risk of its recurrence may be reduced. In case a person develops spontaneous pneumothorax there is fair possibility of its recurring within 2 years. One can reduce the chances of recurrence to some extent by: