Pectus excavatum is a disorder in which the sternumsink enter the body. In the case of the worst, the center of the chest will appear very sunken. Therefore, this condition is also known as a sunken chest.
Pectus excavatum can be detected from birth. As you age, the breastbone tends to move inward. In severe cases, the sternum can put pressure on the heart and lungs. As a result, the performance of the two organs is disrupted.
Pectus excavatum is more common in boys than girls. Even so, in general the condition of pectus excavatum is rare. To overcome this, surgery can be performed.
Causes and Risk Factors of Pectus Excavatum
Until now, the exact cause of pectus excavatum is unknown. However, this condition is thought to be related to heredity. This allegation arises because almost 50% of patients with pectus excavatum have a family with the same condition.
Boys are known to be more at risk of developing pectus excavatum than girls. This condition is also more common in people with the following conditions:
- Marfan Sindrom syndrome
- Turner syndrome
- Noonan syndrome
- Ehlers-Danlos syndrome
- Bone disease due to genetic disorders osteogenesis imperfecta)
Symptoms of Pectus Excavatum
Most cases of pectus excavatum are not very visible, because the chest is only slightly sunken. The shape of the chest that is not too concave does not cause any complaints. However, in some cases, the chest will become more sunken with age.
When to go to the doctor
In severe cases, the sternum can put pressure on the lungs and heart. Go to the doctor immediately if you experience:
- Recurrent respiratory tract infections
- Heart beat
- Feel tired faster
- Chest pain
- Hard to breathe
Diagnosis of Pectus Excavatum
Doctors can detect pectus excavatum only by performing a physical examination of the patient's chest. However, the doctor will perform several follow-up examinations to see the complications that arise from pectus excavatum:
Chest X-ray or CT Scan
Chest X-rays and CT scans aim to check the severity of pectus excavatum, and see if the bones are pressing against the lungs and heart.
Electrocardiogram (ECG)
An EKG is used to check the heart's electrical activity and heart rhythm.
Heart echo
Cardiac echo is performed to check the work of the heart and heart valves, associated with a depression in the chest.
Lung function test
Pulmonary function tests or spirometry are performed by measuring the amount of air the lungs can hold and how quickly the air is expelled from the lungs.
Heart exercise test
This test aims to monitor the work of the heart and lungs during exercise, for example when cycling or running.
Pectus Excavatum Treatment
Pectus excavatum that does not cause complaints does not require special treatment. Sometimes patients are advised to undergo physiotherapy, which can help improve posture and widen the patient's chest.
If pectus excavatum causes heart or lung disorders, there is no therapy other than surgery that can treat pectus excavatum. The types of operations that can be performed are:
Operation Nuss
This procedure is performed by a surgeon who specializes in the chest and heart, by making small incisions on both sides of the patient's chest. Through the incision, curved metal is inserted to lift the breastbone into its normal position. The metal will be removed after two or three years.
Operation Ravitch
In this procedure, the doctor will make a horizontal incision in the center of the chest, to see directly the patient's breastbone. Then, the doctor will remove some of the cartilage around the breastbone, then support it with metal to fix the position of the bone. The metal will be removed after 6-12 months.
Complications of Pectus Excavatum
Pectus excavatum can cause complications such as:
Heart and lung disorders
The sunken sternum can compress the lungs, so that the air space of the lungs is reduced. Bones can also put pressure on the heart. As a result, the heart's work in pumping blood is reduced.
Confidence problems
Children with pectus excavatum tend to have a stooped posture. This condition can make children feel insecure and avoid certain activities, such as swimming.
