Pectus excavatum
Pectus excavatum is also known as funnel chest. Instead of being level with the ribs, the breastbone (sternum) is “sunken” so that the middle of the chest looks “caved in”. The deformity may be the same on both sides or may be more prominent on one side of the chest.
Pectus excavatum affects about one to three in a thousand children. It is three to four times as common in boys as in girls.
Selfcare and more information
What causes pectus excavatum
Pectus excavatum is usually noticeable soon after birth or may develop during a rapid growth spurt in childhood or adolescence. In many cases, we don’t know what causes it, but it seems to be linked to the cartilage in the ribcage overgrowing. It can run in families and may be an inherited condition. About one in ten people with funnel chest also have scoliosis (curvature of the spine).
More rarely, funnel chest may develop as part of a rare genetic disorder such as Marfan syndrome or Noonan syndrome.
Symptoms of pectus excavatum
In many cases, the deformity does not cause any symptoms, apart from the shape of the chest. You do not need to seek medical advice if your child is asymptomatic.
The appearance of the ribcage can make children self-conscious, and cause psychological distress with concerns about appearance, withdrawal and social isolation. It is important to realise that not every child is affected in this way.
Some of those affected may experience symptoms due to an impact on their lung or heart function such as chest pain, breathlessness after exercise, fatigue, fast heart rate and fainting or dizziness.
If your child has symptoms, then you are advised to contact your GP.
Diagnosis of pectus excavatum
This is by the typical shape of the chest. If the child has symptoms suggesting that their lungs or heart are affected, then they may need referral to a paediatrician as they may also need tests to see how well their lungs and heart are working.
Treatment of pectus excavatum
There are several non-surgical management options to support people diagnosed with pectus excavatum. These include posture and exercise programmes, bracing and psychological support.
Surgical management for pectus excavatum is not routinely commissioned on the NHS.
In exceptional cases, your GP or consultant can apply to a specialised funding panel. The panel members will look at the circumstances of the case and whether these are an exception for which NHS funding can be considered.
Further information
The below link explains the procedures taken and the decision that has been made about commissioning surgery through the NHS for pectus deformity
Waiting for a specialist opinion
If you have been referred for a specialist opinion your details will be reviewed, and it may be recommended that you are seen by a hospital clinician. Information to support you in choosing your preferred hospital, including waiting times can be found using the links below.
How long will I wait?
If a hospital assessment and/or treatment is clinically recommended your information will be sent to a specialist. Click below to find out more about waiting times for routine hospital assessment and/or treatment.