Pectus excavatum is also known as sunken chest or funnel chest. It occurs when the cartilage, the bones of the sternum (breastbone) and the ribs do not properly form. The cartilage and the bones are instead pushed inward, leading to a "caved in" appearance of the chest. The condition often goes unnoticed until puberty, when rapid growth and development may intensify the appearance of the defect.

Some adolescents with pectus excavatum do not experience any symptoms and many patients will not require surgical correction. When symptoms are present, patients may complain of pain in the chest, back and elsewhere, as well as shortness of breath and early fatigue. This is because pectus deformities can affect function of the heart and lungs. There may also be psychological and social implications because it affects the appearance of the chest wall.

In some patients, there can be a genetic component to pectus excavatum. It may be more common in adolescents who have another family member with the condition. In addition, some patients with pectus deformities also have inherited connective tissue disorders such as Marfan syndrome, homocystinuria or Ehlers-Danlos syndrome.

How is Pectus Excavatum (Funnel Chest) Diagnosed?

Our patients go through a series of diagnostic tests, including:

  • CT chest scan to evaluate the internal chest anatomy and structure. A CT scan also allows physicians to calculate the Haller Index, an indicator of the severity of the pectus excavatum deformity.
  • Echocardiogram ultrasound to evaluate the heart structure and function
  • Pulmonary function tests (PFTs) to evaluate lung function
  • Metal allergy testing for bar placement that's used in certain treatments; patients with an allergy to nickel will require a special type of bar be placed

How is Pectus Excavatum (Funnel Chest) Treated?

Moderate and severe cases of pectus excavatum often require surgical correction. The minimally invasive Nuss procedure and the modified (small scar) Ravitch procedure are the most commonly used approaches. The team of experts in the Chest Wall Deformity Program at the University of Chicago Medicine Comer Children's Hospital works with families to evaluate each individual case and determine the best treatment option.

If surgery is necessary, it typically occurs when a patient is between 14 and 18 years of age. Children under 14 or older than 18 may also be candidates for surgery, but very young children usually are not unless there are other indications, such as the risk of thoracic dystrophy, which can limit the appropriate growth of the chest wall.

Our team of UChicago Medicine experts also provide specialized care for pectus excavatum in adults.