What is the cause of pectus excavatum?

Answer 1

Definition

Pectus excavatum describes an abnormal formation of the rib cage that gives the chest a caved-in or sunken appearance.

Alternative Names

Funnel chest

Considerations

Pectus excavatum is a congenital (present at birth) abnormality that can be mild or severe. It usually develops during pregnancy.

It is caused by too much growth of the connective tissue that joins the ribs to the breastbone. This causes the sternum to malform inward. The child typically has a depression in the center of the chest over the sternum, and this may appear quite deep.

If pectus excavatum is severe, it may affect the heart and lungs, making exercise difficult. Also, the appearance of the chest may cause psychological difficulty for the child.

Pectus excavatum may occur as the only abnormality, or together with other syndromes. Often, patients also have a heart problem called mitral valve prolapse.

Common Causes

Pectus excavatum will often occur by itself without any family history or other defects or problems. Other causes include:

• Familial pectus excavatum
• Marfan syndrome
• Poland syndrome
• Rickets
• Scoliosis

Call your health care provider if

Contact your health care provider if:

• You develop chest pain
• You develop trouble breathing
• You feel depressed or angry about your condition
• You notice decreased exercise tolerance
• You notice redness, swelling, or discharge from the area

What to expect at your health care provider's office

Your health care provider will perform a physical examination. An infant with pectus excavatum may have other symptoms and signs that, when taken together, define a specific syndrome or condition.

The health care provider will also ask questions about you or your child's medical history, such as:

• When did you first notice this?
• Is it getting better, worse, or staying the same?
• Have any other family members had an unusual-shaped chest?
• What other symptoms are there?

Tests may be done to rule out suspected disorders. These tests may include:

• Chromosome studies
• Enzymeassays
• Metabolic studies
• X-rays

Pulmonary or cardiac function tests may be done to determine how severely the lungs and heart are affected.

This condition can be surgically repaired. Surgery is generally advised if you have other problems, such as trouble exercising. In addition, some people undergo surgery for cosmetic reasons. Your health care provider can help you make decisions about your therapy.

References

Sugarbaker DJ, Lukanich JM. Chest wall and pleura. In: Townsend CM Jr., Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 57.

Tzelepis GE, McCool FD. The lungs and chest wall disease. In: Mason RJ, Broaddus VC, Martin TR, et al, eds.Murray and Nadel's Textbook of Respiratory Medicine. 5th ed.Philadelphia,Pa: Saunders Elsevier; 2010:chap 88.

Reviewed By

Review Date: 12/12/2011

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Answer 2

Definition

Pectus excavatum describes an abnormal formation of the rib cage that gives the chest a caved-in or sunken appearance.

Alternative Names

Funnel chest

Considerations

Pectus excavatum is a congenital (present at birth) abnormality that can be mild or severe.

It is caused by too much growth of the connective tissue that joins the ribs to the breastbone. This causes the sternum to malform inward. The child typically has a depression in the center of the chest over the sternum, and this may appear quite deep.

If pectus excavatum is severe, it may affect the heart and lungs, making exercise difficult. Also, the appearance of the chest may cause psychological difficulty for the child.

Pectus excavatum may occur as the only abnormality, or together with other syndromes.

Common Causes

Pectus excavatum will often occur by itself without any family history or other defects or problems. Other causes include:

• Familial pectus excavatum
• Marfan syndrome
• Poland syndrome
• Rickets

Call your health care provider if

Contact your health care provider if:

• You develop chest pain
• You develop trouble breathing
• You feel depressed or angry about your condition
• You notice decreased exercise tolerance
• You notice redness, swelling, or discharge from the area

What to expect at your health care provider's office

Your health care provider perform a physical examination. An infant with pectus excavatum may have other symptoms and signs that, when taken together, define a specific syndrome or condition.

The health care provider will also ask questions about you or your child's medical history, such as:

• When did you first notice this?
• Is it getting better, worse, or staying the same?
• Have any other family members had an unusual-shaped chest?
• What other symptoms are there?

Tests may be done to rule out suspected disorders. These tests may include:

• Chromosome studies
• Enzymeassays
• Metabolic studies
• X-rays

Pulmonary or cardiac function tests may be done to determine how severely the lungs and heart are affected.

This condition can be surgically repaired. Surgery is generally advised if you have other problems, such as trouble exercising. In addition, some people undergo surgery for cosmetic reasons. Your health care provider can help you make decisions about your therapy.

References

Tzelepis GE, McCool FD. The lungs and chest wall disease. In: Mason RJ, Murray JF, Broaddus VC, Nadel JA. Murray and Nadel's Textbook of Respiratory Medicine. 4th ed. Philadelphia, Pa; 2005:chap 83.

Sugarbaker DJ, Lukanich JM. Chest wall and pleura. In: Townsend CM Jr., Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 57.

Answer 3

The exact cause is not known, but it is believed to be due to overgrowth of the rib cartilage connected to the sternum, which results in the sternum being pushed backward toward the spine