What are chest wall deformities (Pectus excavatum and Pectus carinatum)?

Conditions that affect the physical appearance of the chest are referred to as chest wall deformities that typically happen when the cartilages connecting the ribs to the breast bone grow abnormally. There are two reasons to treat them.

1. When a patient’s mental health is affected and they struggle with self-esteem, body image, and/or bullying and the depression that can result
2. When a patient’s physical health is affected and the deformity impacts the heart and lungs (as seen with poor endurance, inability to participate in sports activities, or even simple tasks like walking around the block or climbing a flight of stairs.) These can be caused by compression of the heart or restriction of the lungs.

Our chest wall program helps hundreds of children, teens and even adults not only renew their self-esteem but also realize their full physical potential and health through improved endurance and activity. Our team understands the delicate medical and mental health implications of chest wall conditions – and we’re here every step of the way.

What types of chest wall deformities do you treat?

Our team has extensive experience diagnosing and treating chest wall deformities, including:

• Pectus excavatum: This affects 1 in 300 patients, making it one of the most common chest wall deformities. It happens when a child’s chest is sunken in or depressed. People commonly refer to this as “sunken chest” or “funnel chest.”
• Pectus carinatum: Also known as pigeon chest, pectus carinatum is a deformity of the chest wall in which the breastbone (sternum) and ribs are pushed outward.

Signs and symptoms

Common symptoms of chest wall abnormalities can include:

• Hollowed depressions in the chest that can be symmetrical or irregular
• Bulging or bird-like appearance to the chest
• A curvature of the spine, absence of the curve of the upper back (scoliosis)
• Hooked shoulders and a broad thin chest
• Difficulty breathing or shortness of breath during exercise
• Chest pain
• Recurrent lung infections
• Heart palpitations (rare)
• Poor self-esteem or body image exacerbated by bullying or teasing

Many children and teens don’t have physical pain or symptoms, but might be concerned about the appearance of their chest and would like to correct it for increased self-confidence.

What causes chest deformities?

We don’t really know though some research indicates there is a genetic or hereditary component. Frequently more than one family member will be affected, although most cases are sporadic and not inherited. Your child can be born with a chest wall deformity, or it could develop later during the adolescent years.

Conditions that are associated with chest wall deformities include:

• Marfan syndrome
• Poland syndrome
• Rickets
• Scoliosis
• Trisomy 18 or 21
• Homocystinuria
• Morquio syndrome
• Multiple lentigines syndrome
• Osteogenesis imperfecta

Diagnosing and treating chest wall deformities

At your first appointment, you will meet with Dr. Yeh and discuss care options. We will work together to create a tailored plan to best suit the needs of your child.

Most patients need the following testing to help us determine the best and safest way to approach care:

• Cardiology evaluation with
  • Echocardiogram
  • EKG
• Chest X-ray
• Chest CT scan (to look for compression or displacement of the heart)
• Genetics testing (in some cases)
• Allergy testing (for allergies to stainless steel or metals)
• Pre-operative testing

After diagnosis, our cardiothoracic surgeon will work with your family to recommend the best treatment option for your child. The options can range from non-surgical techniques to minimally invasive surgery, depending on the severity of the condition. In certain rare cases, more invasive surgery might be recommended.

Learn more about our chest wall deformity treatment options