Pectus Excavatum: Causes, Symptoms, Risk Factors, Diagnosis and Treatment

Pectus excavatum causes the breastbone to protrude into the chest of the affected individual. A large depression in the chest that appears to have the center removed can be left by severe cases of pectus excavatum.

As the adolescent development spurt approaches, pectus excavatum normally worsens, even though the sunken breastbone is often seen shortly after birth.

Cardiovascular and pulmonary function may be compromised in extreme pectus excavatum cases. Children with milder forms of pectus excavatum, however, could feel self-conscious about their appearance. Through surgery, the deformity can be fixed.

Causes Of Pectus Excavatum

Although the precise cause of pectus excavatum is uncertain, given that it occasionally runs in families, it may be a genetic disorder.

Symptoms Of Pectus Excavatum

For most people, pectus excavatum simply manifests as a little indentation in the chest. In some people, beginning in early adolescence, the indentation's depth may continue to worsen throughout maturity.

When pectus excavatum is severe, the breastbone may compress the heart and lungs. Among the signs and symptoms are:

• A decreased capacity to exercise
• Recurrent respiratory illnesses
• Palpitations or a rapid heartbeat
• Chest pain
• Coughing or wheeze
• Heart murmur
• Tiredness
• Drowsiness

Risk Factors Of Pectus Excavatum

Boys are more likely than girls to get pectus excavatum. Additionally, it happens more frequently in those who also have:

• The Marfan syndrome
• The Ehlers-Danlos syndrome
• Imperfecta osteogenesis
• The Noonan syndrome
• Turner syndrome

Diagnosis Of Pectus Excavatum

Usually, pectus excavatum can be diagnosed with a simple chest examination. Your doctor may suggest a variety of tests to check for associated lung and heart conditions. These examinations could include:

• CT scan of the chest: This examination can show a dip in the breastbone and often shows the heart shifted to the left side of the chest. X-rays are rapid, painless procedures that only take a few minutes to complete.
• A CT scan or an MRI: The extent of the pectus excavatum and if the heart or lungs are being crushed can both be determined by these tests. With CT and MRI scans, several pictures are obtained from different angles to produce cross-sectional images of the body's internal anatomy.
• Electrocardiography: A heart electrocardiogram (ECG) can show whether the heart is beating regularly or irregularly and how precisely the electrical impulses that control the heartbeat are timed. This test is painless and involves placing over a dozen electrical leads on the body that are attached with sticky adhesive.
• The echocardiogram: The word "echocardiography" describes an ultrasound of the heart. Images of the heart and its valves can be seen in real-time. A wand that is pressed against the chest allows sound waves to travel through and create the images. Your doctor may also look into the potential that the chest wall influences blood flow and heart function using an echocardiography. 
• Lung function evaluation: These tests determine how much air your lungs can hold in them and how quickly they can empty. 
• Checking Impact Of Exercises: This examination keeps track of how well your heart and lungs function as you exercise, usually on a bike or treadmill. 

Treatment Of Pectus Excavatum

Surgery is a treatment option for pectus excavatum, though it is often reserved for those with moderate to severe symptoms. For people with mild signs and symptoms, physical therapy could be helpful. Some exercises can improve posture and the extent of chest expansion.

If you're not experiencing any discomfort from the depression in your breastbone but you don't like the way it appears, you may consider having a silicone insert, which resembles a breast implant, inserted under your skin to fill up that area.

Also Read: Hepatitis C : Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Prevention and Complications

Surgical Fixation

The names of the two surgeons who developed the most widely used surgical methods for treating pectus excavatum are as follows:

• Nuss method: This minimally invasive procedure involves making small incisions on both sides of the chest. Long-handled instruments and slender fiber-optic cameras are put through the incisions. A curved metal rod is threaded beneath the depressed breastbone to lift it into a more normal position. Sometimes more than one bar is used. 
• Ravitch Technique: During this earlier procedure, a larger incision is made down the middle of the chest. The surgeon utilizes surgical gear, such as a metal strut or mesh supports, to straighten the breastbone after removing the faulty cartilage that held the ribs to the lower breastbone. These supports are terminated after a year.

Most individuals who undergo surgery to repair pectus excavatum are satisfied with how their chests look presently, regardless of the method of treatment used. Pectus excavatum repair has proven beneficial for many individuals, even though most of these treatments are performed during the puberty growth spurt.

There are many options available for pain treatment following surgery to promote healing. By temporarily freezing the nerves, cryoablation can promote healing and reduce postoperative pain for four to six weeks after surgery.

Also Read:

Complications Of Pectus Excavatum

Severe forms of pectus excavatum can cause the heart to tilt to one side or compress the lungs and heart. Problems with one's self-image can arise from even minor cases of pectus excavatum.

Heart and Lung Conditions

If the breastbone indentation is deep, the lungs' ability to expand may be restricted. The heart may also be squeezed by the compression, which would push it against the left side of the chest and reduce its ability to pump blood efficiently. Some symptoms that may arise from this include exercise intolerance, dyspnea, an elevated heart rate, and chest tightness or pain.

Self-Perception Problems

Patients with pectus excavatum usually have forward-leaning shoulders and prominent ribs. Because they are self-conscious about their appearance, many people stay away from activities like swimming where their chest is visible. Additionally, they would avoid wearing anything that might make it more difficult to hide the indentation in their chest.

Download the PrepLadder App and get the best neet pg online coaching with world-class video lectures, QBank, Mock Tests and more!

Download PrepLadder's best app for neet pg preparation for Android 

Download PrepLadder's best app for neet pg preparation for ios