Do I have Severe or Mild Pectus Excavatum?

Also known as “sunken chest”, pectus excavatum is usually primarily a cosmetic concern but can cause a wide range
of symptoms. The condition is usually mild with minimal or no symptoms. Some patients are more severe with more
complicated symptoms. This section will provide guidance on the common symptoms of pectus excavatum and how to
tell whether you have mild or severe pectus excavatum

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What are the common symptoms of pectus excavatum?

The most obvious symptom of pectus excavatum is a chest wall deformity, where the chest appears to sink inwards. Associated physical symptoms that may occur with pectus excavatum include:

Shortness of breath with exercise
Decreased stamina compared to peers
Fatigue
Chest pain
Irregular heartbeat

The appearance of the chest deformity in people with pectus excavatum can cause psychological symptoms. These can include embarrassment, self-esteem issues and even depression in severe cases.

Pectus excavatum symptoms in adults

Pectus excavatum is commonly noticed in the early teen years, and many adults with pectus excavatum will have been aware of their symptoms for years. Symptoms can sometimes get worse with age.

How severe is my pectus excavatum?

The severity of the defect and the asymmetry of the chest widely vary. In severe cases of pectus excavatum, the breastbone may compress the lungs and heart. Your pectus excavatum is more severe if you are affected by the following:

Chest pain
Heart problems
Breathing problems
Rapid heartbeat or heart palpitations
Recurrent respiratory infections
Wheezing or coughing
Chest pain
Heart murmur

Although some severe symptoms are obvious, it is important to have a CT scan to determine the severity of your pectus excavatum. This is used to see what method of surgery is ideal for you. Chest imaging by MRI or CT scan and cardiopulmonary exercise testing accurately measures how serious the pectus is. It also tests its effect on the function of the heart and lungs. Images from a CT scan are used to ascertain your Haller index. This measures the horizontal distance of the inside of the ribcage and the shortest distance between the vertebrae and sternum to determine how severe the deformity is. A normal Haller index is around 2.5, however people with severe pectus excavatum can have an index as high as 5.5 (source).

What do I do if I think my pectus excavatum is severe?

If you are worried about your pectus excavatum symptoms, it is important to talk to your Doctor or GP. They may put you through for more tests and recommend a method of surgical repair if you have severe physical symptoms. The Nuss Procedure or Ravitch Procedure are designed for severe pectus excavatum. You can read more about the surgery options for pectus excavatum here.

What is mild pectus excavatum?

If you notice a small dent in your chest, however, don’t have any physical symptoms, you likely have a mild case of pectus excavatum. A normal chest has a Haller index of 2 or less. A Haller index between 2 and 3.2 is considered a mild deformity; between 3.2 and 3.5, moderate.; 3.5 or greater, a severe deformity (source).

If you have appearance concerns caused by pectus excavatum and are self-conscious about your symptoms, you may want to consider implant surgery. You can read more about implant surgery here. You can read more about implant surgery here.

How to look out for symptoms in children

If your child has pectus excavatum, you may notice a dint in the child’s chest when they are of primary school age. Often it gets worse when the child is aged between 12 and 14.

Pectus excavatum does not always cause other symptoms, especially before the teen years. A moderate to severe case can cause:

Shortness of breath with exercise
Trouble breathing
High concern with body image

Children who have pectus excavatum may also have the following conditions:

Poland syndrome. This is a birth defect marked by missing or underdeveloped muscles on one side of the body. This is particularly noticeable in the major chest muscle
Marfan syndrome: a disorder that affects the body’s connective tissue
Scoliosis. This is a disorder in which the spine curves incorrectly
Rickets. This is a disorder that leads to softening and weakening of the bones. It can be caused by a lack of vitamin D, calcium, or phosphate.

In some cases, pectus excavatum runs in families, so it can be useful to keep an eye out for symptoms in your child if any of your family have pectus excavatum.

When is pectus excavatum a problem?

Treatment should be sought if you have physical symptoms such as breathing difficulties, or psychological symptoms that affect daily life.

Can exercise fix my pectus excavatum?

Exercise cannot cure pectus excavatum; however, it can have the following effects in some mild cases:

Developing the upper body area
Expanding the lungs capacity
Improving posture
Adding muscle mass to the pectorals and spine muscle

Although exercise is successful in some cases, it is not as effective as a surgical correction. There is also no guarantee that it will be effective.

You can read more about exercise for pectus excavatum in our guide Pectus excavatum exercise: the natural alternative to surgery for some patients.

Surgery for pectus excavatum

While mild symptoms can be treated with natural remedies such as exercise, a pectus excavatum patient with severe pectus deformity can choose a surgical procedure. You can read our full guide the different treatment options of pectus excavatum here.

Implant surgery is a non-invasive procedure that involves producing a purpose-built implant to replicate the missing contour of the sternum and ribs. You may want to consider implant surgery if you are a patient with pectus excavatum.

To find out how Stephen McCulley can help you, you can get in touch here.

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