Common Terms for Pectus Excavatum
While 'pectus excavatum' is the clinical term, a few common colloquial names are also used to describe the condition:
Funnel Chest
The term 'funnel chest' is one of the most widely used alternative names for pectus excavatum. It directly references the characteristic depression in the center of the chest, which can resemble a funnel. This name is frequently used by both medical professionals and the general public due to its vivid description.
Sunken Chest
Another descriptive alternative is 'sunken chest'. This name points to the overall appearance of the chest wall, where the breastbone and ribs seem to have been pushed inward or 'sunken'. Like 'funnel chest', this term is easily understood and conveys the primary visual symptom of the deformity.
Hollow or Concave Chest
Less common but still used are the terms 'hollow chest' and 'concave chest'. These are more general descriptions but accurately reflect the physical appearance of the chest. The term 'hollow chest' emphasizes the depth of the indentation, while 'concave chest' is a more technical description of the shape.
Cobbler’s Chest
The historical term 'cobbler’s chest' refers to the occupation of a shoemaker, who would press leather against their chest to create shoes. The repetitive motion was thought to lead to a chest deformity, though this is not the actual cause of pectus excavatum. This term is rarely used today but may be found in older medical texts.
Causes and Associated Conditions
The exact cause of pectus excavatum is not definitively known, but it is believed to be linked to an overgrowth of the costal cartilage, which connects the ribs to the breastbone. This abnormal growth pushes the sternum inward. The condition often has a genetic component and can run in families, with a significant number of patients having a family member with the same or a similar chest wall deformity.
Associated with Connective Tissue Disorders
In some cases, pectus excavatum is associated with underlying connective tissue disorders. These include:
- Marfan Syndrome: A genetic disorder that affects the body's connective tissue.
- Ehlers-Danlos Syndrome: A group of inherited disorders that affect connective tissues, primarily skin, joints, and blood vessel walls.
- Noonan Syndrome: A disorder that causes many parts of the body to develop abnormally.
Symptoms and Diagnosis
In addition to the visible chest wall depression, some individuals with moderate to severe cases of pectus excavatum may experience physical symptoms, especially during puberty or periods of rapid growth. These symptoms can include:
- Shortness of breath
- Decreased exercise tolerance or early fatigue
- Chest pain
- Heart palpitations
- Low self-esteem or psychological distress due to appearance
Diagnosis involves a physical examination, but additional tests are often used to assess the severity and potential impact on heart and lung function. These tests may include:
- CT Scan: Used to create a detailed image of the chest and measure the Haller index, which is a ratio of the transverse diameter to the anterior-posterior diameter of the chest. A higher index indicates greater severity.
- Echocardiogram: An ultrasound of the heart to assess its function and identify any compression or displacement.
- Pulmonary Function Tests (PFTs): Measure lung capacity and function.
Treatment Options
Treatment for pectus excavatum varies depending on the severity of the condition and the presence of symptoms. Mild cases often don't require treatment, but moderate to severe cases may benefit from intervention. Treatment options include:
Non-Surgical Options
- Observation: For mild cases, especially in young children, doctors may simply monitor the condition as they grow.
- Vacuum Bell Therapy: This non-invasive treatment involves using a suction-cup-like device to gradually lift the sternum over time. It is most effective for young, mild to moderate cases with flexible chest walls.
Surgical Correction
For more severe cases, surgical repair may be recommended, particularly during the teenage years for best results.
- Nuss Procedure: A minimally invasive technique where a curved metal bar is inserted under the sternum to push it into the correct position. The bar is typically removed after two to four years.
- Modified Ravitch Procedure: An open surgery where the surgeon removes the overgrown cartilage and repositions the breastbone. A metal bar may be used for support during healing.
Pectus Excavatum vs. Pectus Carinatum
It's important to differentiate between pectus excavatum and its counterpart, pectus carinatum, also known as 'pigeon chest'.
| Feature | Pectus Excavatum | Pectus Carinatum |
|---|---|---|
| Appearance | Sunken or caved-in chest. | Protruding or bowed-out chest. |
| Skeletal Abnormality | Inward growth of the sternum. | Outward growth of the sternum. |
| Prevalence | Most common chest wall deformity. | Less common than pectus excavatum. |
| Nickname | Funnel chest, sunken chest. | Pigeon chest. |
Conclusion
While the medical term is pectus excavatum, the condition is most commonly referred to as funnel chest or sunken chest, with other less frequent synonyms also used. The diagnosis and treatment depend on the severity, but options are available for those experiencing physical or psychological symptoms. Understanding the different terminology is a key first step for anyone navigating this chest wall deformity. For more detailed information, consult authoritative sources such as major health systems. The UCLA Health pediatric surgery department provides excellent resources and insights on chest wall deformities like pectus excavatum, which you can read more about here: https://www.uclahealth.org/medical-services/pediatric-surgery/clinical-services/pectus-excavatum-and-carinatum-repair.
