Sunken chest

Sunken chest, also known as pectus excavatum, is a congenital deformity of the anterior wall of the thorax where the sternum and rib cage grow abnormally. This results in a caved-in or sunken appearance of the chest. It is the most common congenital chest wall abnormality in children, though its exact cause is not fully understood. The condition can range from mild to severe and can impact both physical health and psychological well-being.

Causes and Risk Factors

The exact cause of pectus excavatum is unknown, but it is thought to result from an abnormal growth of the cartilage that connects the ribs to the sternum, causing the sternum to grow inward. Genetic factors may play a role, as the condition sometimes runs in families. There are no known lifestyle risk factors for developing pectus excavatum, indicating that the condition is primarily due to genetic predisposition.

Symptoms and Complications

The most noticeable symptom of pectus excavatum is the sunken appearance of the chest, which can vary in severity. In mild cases, the condition may be purely cosmetic. However, in more severe cases, it can affect lung and heart function. Symptoms may include shortness of breath, especially during exercise; chest pain; and fatigue. The condition can also impact self-esteem and mental health due to its appearance.

Diagnosis

Diagnosis of pectus excavatum typically involves a physical examination and medical history. Imaging tests, such as chest X-rays, CT scans, or MRI scans, may be used to assess the severity of the deformity and its impact on the heart and lungs.

Treatment

Treatment options for pectus excavatum vary depending on the severity of the condition and the symptoms it causes. For mild cases, no treatment may be necessary. Physical therapy exercises can sometimes improve posture and the appearance of the chest. For more severe cases, surgery may be recommended to correct the deformity. The most common surgical procedure is the Nuss procedure, which involves inserting a curved metal bar under the sternum to push it outward. The bar is usually left in place for several years before being removed.

Prognosis

The prognosis for individuals with pectus excavatum varies. Many people live normal, healthy lives with the condition. Surgical correction can significantly improve the appearance of the chest, as well as respiratory and cardiac function in severe cases. However, as with any surgery, there are risks involved, and the decision to undergo surgery should be made on an individual basis.

Psychological Impact

The psychological impact of pectus excavatum should not be underestimated. Individuals with the condition may experience body image issues, low self-esteem, and social anxiety. Support from family, friends, and support groups, as well as counseling, can be beneficial.