Pectus excavatum (funnel chest)

Pectus excavatum is when your breastbone (the bone in the middle of your chest) curves inwards and there’s a dip between your ribs. Your chest can appear sunken or hollow.

The dip can be the same on both sides (symmetrical) or affect one side more than the other (asymmetrical).

Pectus excavatum, also known as ‘funnel chest’, is different for everyone. Most people are born with pectus excavatum. But it’s usually more noticeable in childhood, or as a teenager, after a growth spurt.

How common is pectus excavatum?

In the UK, around 1 in 1,000 babies are born with pectus excavatum.

It’s around four times more likely in males than females.

It’s not known for sure what causes pectus excavatum. It can run in families, but more research is needed.

Sometimes it happens as you grow or as part of a rare genetic condition, such as Marfan syndrome and Ehlers-Danlos syndrome.

Most people with pectus excavatum do not have any symptoms.

Rarely some people with severe pectus excavatum have:

• chest pain
• breathlessness after exercise
• fainting or feeling dizzy
• finding it hard to eat or swallow. This is called dysphagia.

Healthcare professionals usually diagnose pectus excavatum by looking at your chest.

A CT scan can look at the space inside of your chest. It can also check if your chest is pushing on your heart or lungs.

If you have severe pectus excavatum, you may have a cardiopulmonary exercise test (CPET). This test can see how well your heart, lungs and muscles are working together when you exercise.

Most people with pectus excavatum will not need treatment.

In some areas of the UK, there are some treatments for severe pectus excavatum.

Not every part of the UK offers the same treatment for pectus excavatum. Speak to your GP for more information.

Vacuum bell

The vacuum bell is the only non-surgical treatment for pectus excavatum.

It’s a rubber, bell-shaped object that connects to a hand pump.

Doctors place the bell on the chest and use the pump to suck the air out. This creates a suction that helps to lift the sunken area of the chest. This may feel uncomfortable, but it should not be painful.

It’s not clear how long the effects will last after the treatment stops.

Surgery

Surgery may be an option for people with very severe pectus excavatum.

It can help to improve the shape of the chest. But surgery isn’t right for everyone.

If you’re eligible for surgery, your surgeon will talk to you about the risks and benefits.

Nuss procedure

The Nuss procedure is a type of surgery for some adults and older children with severe pectus excavatum.

Two small cuts are made on both sides of the chest to lift the ribs, breastbone and cartilage (a type of tissue that connects your ribs and breastbone). These are body parts that make up the chest wall.

One or two metal bars, called pectus bars, are placed under the chest wall to hold it in shape. The metal bars are usually removed after two to three years.

Ravitch procedure

The Ravitch procedure is a type of open surgery for adults with complex pectus excavatum.

A large cut is made to reshape the chest wall (such as the ribs, breastbone and cartilage).

To keep the chest in the right shape, one or more metal bars, or mesh support, are placed under the chest wall. The metal bars are usually removed after two to three years.

If you're eligible for surgery, your surgeon will talk to you about the risks and benefits.

Here are some things you can try to live well with pectus excavatum:

Keep active

It’s a good idea to stay as active as possible to look after your heart and lungs.

Moving more can make your muscles stronger and help you to breathe more easily.

Try our Keep Active programme to help you move more at a pace that suits you.

Having good posture

People with pectus excavatum are more likely to have scoliosis. This is where the spine is curved or twisted.

Stretches and exercises can strengthen your muscles and help to improve your posture. This is the position you hold your body in when you’re sitting, standing or lying down.

Eating a healthy diet

Eating well is important for your health. A balanced diet with the right vitamins and minerals can help you stay strong.

We have more information about eating well with a lung condition.

Breathing exercises

If you feel short of breath, there are breathing techniques you might find helpful.

Support for pectus excavatum

Living with a long-term condition can impact your everyday life. There is help available:

• read our information about managing your mental health for people with a lung condition
• join one of our support groups or our Health Unlocked forum to connect with other people with similar experiences to you
• Pectus Matters offers specialist support and advice for people living with pectus conditions.