Pectus excavatum (funnel chest)

This page has information on pectus excavatum. Some people know this condition as ‘funnel chest’. Here we explain what pectus excavatum is, the symptoms, and how it can be treated.

What is pectus excavatum?

Pectus excavatum is when the breastbone presses inwards and there is a dip between the ribs.

Pectus excavatum can be symmetrical (the same on both sides) or might affect one side of the chest more.

Some people with pectus excavatum won’t have any other symptoms. For others, it may affect their heart or lung function. Because it affects the shape of their body, some people with pectus excavatum may feel shy or self-conscious. Treatment is available to correct the position of the breastbone.

How common is it?

About 1 in 1,000 children will have pectus excavatum. It’s four times more common in males than in females.

What causes pectus excavatum?

It’s not known for sure what causes pectus excavatum. Sometimes it happens following open-heart surgery. It can run in families and may be an inherited condition, but more research is needed.

About 1 in 10 people with pectus excavatum also have scoliosis (curvature of the spine).

Pectus excavatum may occasionally develop as part of a rare genetic disorder. People with Marfan syndrome or Noonan syndrome may have pectus excavatum.

What are the symptoms?

Pectus excavatum is usually noticeable soon after birth.

Some people with pectus excavatum may not experience any symptoms, except the shape of their chest. Others may experience symptoms including:

  • chest pain
  • breathlessness after exercise
  • extreme tiredness (fatigue)
  • fainting or dizziness
  • fast heart rate (tachycardia).

Symptoms may only start as the person gets older and they may get worse with age.

How is it diagnosed?

Pectus excavatum can be present at birth or might develop during a rapid growth spurt. This usually happens in children aged 10 and older. The doctor will diagnose it by looking at your child’s chest.

They may need an X-ray or CT scan to see whether their lungs are being squashed or compressed. They may also need breathing tests to see how well their lungs are working.

Cardiopulmonary exercise testing (CPET) and heart scans can tell doctors more about how well your child’s heart is working.

What is the treatment?

Mild cases of pectus excavatum may not need treatment if they don’t cause any physical problems.


If the pectus excavatum is more severe, the function of the heart and lungs may be affected, and surgery may be needed.

The surgery for pectus excavatum is called the Nuss procedure. It involves placing one or more stainless steel bars (pectus bars) into the chest, to alter the position of the breastbone. Doctors usually carry out surgery during teenage years.

Your child will need to avoid contact sports for the first six months after surgery. The bars are left in place for 2-3 years before being permanently removed.

Vacuum Bell therapy

In younger children and those not keen on surgery, doctors might use a Vacuum Bell device to correct the shape of the chest. This is a rubber, bell-shaped device, which connects to a pump. Doctors place the bell on the chest and use the pump to suck the air out. This creates a forceful pull that lifts the sunken area of the breastbone. It can be used for up to two hours a day. Vacuum Bell therapy is given in hospital. It may cause discomfort to your child, but it is not a painful therapy.

Doctors don’t use the Vacuum Bell to treat all types of pectus excavatum, but there are several different shapes and sizes available. Vacuum Bell therapy will change the shape of your child’s chest when used correctly. It is not clear how long this will last after therapy stops.

When used according to instructions for 1-2 years, the Vacuum Bell may be effective for many patients.

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