Pectus Excavatum Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Pectus excavatum ( funnel chest ) is a congenital disorder of the bones, in which the sternum will be concave inward. This condition is generally experienced by boys than girls. Pectus excavatum is the most common congenital breastbone disorder (90%), followed by pectus carinatum (5–7%), in which the chest wall protrudes.
In mild conditions, sufferers usually do not have significant complaints. However, in severe conditions, a sufferer will experience various health problems, especially lung and heart health.
Symptoms
In mild circumstances, pectus excavatum does not cause symptoms. However, in severe circumstances, this condition will suppress the heart and lungs, causing various symptoms such as:
- easily tired
- chest pain
- susceptible to respiratory tract infections
- heart rhythm disturbances
Reason
The cause of pectus excavatum is still not known with certainty. However, experts suspect that genetic factors play a role in the occurrence of this breastbone condition. Although the gene that causes this bone disorder has not been found, familial events where there are family members of sufferers with the same disorder, reach 35% of cases.
This disorder is also associated with Marfan syndrome and Poland syndrome. In this bone disorder, there is abnormal growth of bone and cartilage in 4-5 sternum.
Diagnosis
The diagnosis of pectus excavatum begins with a physical examination of the patient’s chest. The patient’s chest will show a concavity in the chest backward. Meanwhile, on cardiac examination, you will hear the heart shifting due to pressure on the patient’s chest that changes the position of the heart.
There are several supporting examinations to help diagnose pectus excavatum, namely:
- Radiological examinations such as a chest X-ray or chest CT scan. The results of X-ray imaging and CT scans will show abnormalities in the sternum. CT scan examination shows in more detail the bone structure and provides information on the severity of pectus excavatum.
The severity of Pectus excavatum can be assessed by calculating the Haller index. The Haller index is calculated by comparing the transverse diameter of the thorax with the anteroposterior diameter of the patient’s thorax. The value of 3.25 is included in the severe category for degrees of pectus excavatum.
- Electrocardiogram can be used to determine the health status of the sufferer’s heart.
- An echocardiogram can be done to check the pumping function of the heart and heart valves directly.
- Lung function test to see the ability of the lungs to breathe. In severe cases, the lungs cannot expand optimally.
Treatment
In mild pectus excavatum conditions, the patient is asymptomatic so physical therapy is an option. Some exercises can help increase the swelling power of the sufferer’s chest.
In severe cases, pectus excavatum can be corrected by surgery. Operative action can be performed using either a small incision or a large incision.
Prevention
There are no precautions that can be taken to avoid pectus excavatum.