What are types of chest deformities?

Pectus excavatum and pectus carinatum are chest wall deformities that happen when several ribs and the breastbone grow abnormally. They cause the chest to sink inward or push outward. For many people with either condition, the only symptom is the chest’s appearance.

Although both may be noticeable at birth, sometimes they aren’t apparent until a child’s growth spurt during puberty when the chest wall sinks or juts out more significantly. It’s best to get treatment at this time before puberty is complete. After puberty, the chest wall is more rigid and more difficult to reposition.

What are the symptoms of pectus excavatum and pectus carinatum?

Pectus excavatum, also called funnel chest, causes the chest to sink inward. More severe cases can press on the heart and lungs, which may cause rapid heartbeats or palpitations (arrhythmias), frequent respiratory infections, or difficulty breathing – especially during exercise – and dizziness.

Pectus carinatum, also called pigeon chest, is a less common disorder that causes the chest to bulge out. It sometimes causes chest pain or shortness of breath, particularly during exercise. It often affects one side of the chest more than the other – sometimes, the other side of the chest can have pectus excavatum.

The causes of pectus excavatum and pectus carinatum are unknown, but they may be inherited conditions since they often run in families. Both conditions affect boys more often than girls. These chest deformities are also more common in people with osteogenesis imperfecta (brittle bone disease), scoliosis, and Edwards, Down, Ehlers-Danlos, Marfan, Noonan, and Turner syndromes.

If you’re looking for treatment for yourself or your child, you can count on the experts at UHealth. We explain all your options to help you decide what’s right for you. Our surgeons use the latest approaches and minimally invasive procedures to treat both children and adults. You get comprehensive care from a highly skilled, experienced team.

Tests

Imaging Exams
We use chest X-rays and other imaging tests like MRI or CT scans to examine your breastbone. Imaging tests can also show whether the breastbone or ribs are pressing against your heart or lungs. Your doctor may do other tests, depending on your symptoms.

Heart Tests
We may use a few noninvasive tests to check your heart function. An electrocardiogram uses adhesive patches with electrodes placed on your chest to check your heart’s electrical signals and heartbeat. An echocardiogram uses ultrasound (sound waves) to show your heart and valves.

Lung Function Tests
Lung function tests measure how much air your lungs can hold and how quickly air moves in and out of them. Tests may include spirometry, plethysmography, gas diffusion, or inhalation challenge tests.

Exercise Stress Test
This test shows how your heart and lungs function during exercise on a stationary bike or treadmill.

Genetic Testing
In some instances, we do a blood test to check for other related genetic syndromes.

Treatments

Chest Bracing for Pectus Carinatum
Children whose bones are still growing can wear a chest brace to press the breastbone back into position. They wear the brace for up to 23 hours a day. Depending on the breastbone’s position, a child may wear the brace for six months to a year. If the pectus carinatum is severe, your doctor may recommend surgery.

Nuss Procedure for Pectus Excavatum
This minimally invasive procedure, called video-assisted thoracoscopic surgery (VATS), uses two small cuts on each side of the chest and another small cut to insert a tiny camera that lets your surgeon see inside your chest. Your surgeon places one or more curved metal bars under your breastbone to push it into the correct position. The bars stay there for two or three years to reshape your breastbone into place, and then they’re removed.

Ravitch Procedure
This open surgery approach may be used for more severe cases of pectus excavatum when the Nuss approach isn’t possible or for pectus carinatum when bracing isn’t an option. Using a larger cut in the center of the chest, your surgeon removes the deformed cartilage causing the deformity and repositions the breastbone. If the procedure is for pectus excavatum, the surgeon may insert a metal bar to hold the breastbone in position.

Why Choose UHealth?

Advanced surgical expertise. As an academic medical center, we offer the latest, proven approaches backed by the leading-edge research of the University of Miami Miller School of Medicine. Our surgeons are known internationally for outstanding surgical care. Doctors worldwide come to UHealth to learn advanced minimally invasive and robotic surgeries.

A comprehensive team. Thoracic surgery specialists work as a team with pediatricians, pedistric surgeons, orthopaedic surgeons, and other specialists to ensure you get complete care. You work with a team that gives you individual attention and treatment that offers you the best possible results.

Improving surgical care through research. We participate in the latest research and clinical trials, which help determine which surgeries work best for patients. This research advances patient care and safety while shaping the future of surgical treatment. Our surgeons have helped develop promising new therapies for a wide range of conditions – approaches that improve safety and help patients recover more quickly.

World-class health care for children. Children and their families come from all over the world to receive top-quality care from our compassionate team of pediatric specialists. Children receive personalized, kid-friendly attention from doctors who are sought out for their expertise.

Recognized for our exceptional pediatric care. Many of our pediatric doctors are recognized as America’s Top Doctors® by Castle Connolly — doctors who are nominated by their peers as being the very best in their communities. We have more Top Doctors than any other health system in South Florida. We’re affiliated with Holtz Children’s Hospital, one of the largest children’s hospitals in the southeastern United States. The hospital is ranked among the nation’s Best Hospitals by U.S. News & World Report in diabetes and endocrinology, gastroenterology and GI surgery, and nephrology.