Funnel chest, medically known as pectus excavatum, is a condition characterized an abnormal inward curvature of the chest wall. This congenital deformity affects the shape and appearance of the chest, creating a sunken or “funnel-shaped” appearance. In this comprehensive guide, we will discuss the causes, symptoms, diagnosis, treatment options, and potential complications associated with funnel chest.
Causes:
The exact cause of funnel chest is not fully understood. However, it is believed to result from the abnormal growth of the rib cartilages and the sternum (breastbone) during fetal development. This abnormal growth leads to the sternum being displaced inward, causing the depression in the chest. Some studies suggest that genetic factors may play a role in the development of this condition, as it often tends to run in families. Additionally, certain connective tissue disorders or syndromes, such as Marfan syndrome or Ehlers-Danlos syndrome, have been linked to an increased risk of funnel chest.
Symptoms:
The symptoms of funnel chest can vary in severity, ranging from mild to severe. Some individuals may have minimal symptoms, while others may experience more noticeable physical and psychological effects. Common symptoms include:
1. Sunken or concave chest:
The hallmark sign of funnel chest is the depression in the chest, which can vary in depth and shape.
2. Shortness of breath:
The abnormal chest shape can compress the lungs, reducing their capacity. This can lead to breathing difficulties during physical exertion or exercise.
3. Chest pain:
Some individuals with funnel chest may experience discomfort or pain in the chest area.
4. Heart murmurs:
In severe cases, the compression of the heart can result in abnormal heart sounds, known as heart murmurs.
5. Poor posture:
Funnel chest can affect posture, causing rounded shoulders or an increased inward curvature of the spine (kyphosis).
6. Psychological impact:
The altered chest appearance may cause self-esteem issues or emotional distress, particularly during adolescence when body image is of significant concern.
Diagnosis:
Diagnosing funnel chest typically involves a combination of physical examination, medical history review, and imaging tests. A healthcare professional, such as a pediatrician, family physician, or thoracic surgeon, may perform the following assessments:
1. Visual examination:
The healthcare provider will visually inspect the chest, looking for the characteristic depression or asymmetry.
2. Medical history review:
This involves discussing the patient’s symptoms, family history, and any known underlying conditions or syndromes.
3. Imaging tests:
X-rays and CT scans of the chest are commonly used to ascertain the severity of funnel chest, evaluate the impact on the heart and lungs, and help guide treatment decisions.
Treatment Options:
The treatment of funnel chest varies depending on the severity of the condition, the presence of symptoms, and the patient’s age. Non-surgical interventions are typically recommended for mild cases, while more severe cases may require surgical correction. Here, we discuss both treatment approaches:
1. Non-surgical interventions:
a. Observation:
In mild cases without significant symptoms, periodic observation a healthcare professional may be sufficient.
b. Physical therapy:
Certain exercises and techniques can help improve posture, strengthen the chest muscles, and enhance lung capacity.
c. Vacuum bell therapy:
This non-invasive technique involves the application of negative pressure using a specialized device, which helps pull the sternum outward gradually.
2. Surgical correction:
a. Ravitch procedure:
Named after the surgeon who developed it, this surgical technique involves reshaping the chest removing the abnormal cartilages and stabilizing the sternum with surgical implants.
b. Nuss procedure:
This minimally invasive approach utilizes a curved metal bar inserted through small incisions to elevate the sternum into a normal position. The bar is left in place for a certain period to allow for chest wall remodeling.
c. Custom implants:
In some cases, custom-made implants may be used to correct the deformity and provide support to the chest wall.
Complications:
While most cases of funnel chest do not cause significant medical complications, severe or untreated cases can be associated with various issues. These may include:
1. Reduced lung function:
The inward curvature of the chest can restrict lung expansion, leading to reduced lung capacity and potential respiratory difficulties.
2. Cardiac compression:
In severe cases, the heart may be compressed and displaced, potentially affecting its function and leading to heart murmurs or irregular heartbeats.
3. Psychological impact:
The altered chest appearance can significantly impact a person’s self-esteem, body image, and overall mental well-being.
4. Physical limitations:
Funnel chest can affect physical abilities, such as reduced endurance, decreased exercise tolerance, and limitations in certain activities.
Funnel chest, or pectus excavatum, is a congenital condition affecting the chest wall, characterized an inward curvature of the sternum. It may be caused abnormal growth during fetal development and can result in a sunken or “funnel-shaped” chest appearance. While mild cases may require minimal intervention, severe cases may necessitate surgical correction. It is important to consult with a healthcare professional for an accurate diagnosis and appropriate management of funnel chest to address any associated symptoms and potential complications.