What is it called when the middle of your chest goes in?: Understanding Pectus Excavatum

September 28, 2025 •

4 min read

Affecting approximately 1 in 400 births, the medical term for when the middle of your chest goes in is pectus excavatum. This chest wall deformity is also colloquially known as 'funnel chest' or 'sunken chest' and involves an abnormal growth of cartilage that pulls the breastbone inward.

Quick Summary

The medical term for a caved-in chest is pectus excavatum, also known as funnel chest, a congenital chest wall abnormality where the sternum and rib cartilage grow inward. While mild cases may be asymptomatic, more severe ones can compress the heart and lungs, causing symptoms like fatigue, shortness of breath, and chest pain, often becoming more pronounced during growth spurts.

Key Points

Pectus Excavatum: The medical term for a sunken or hollowed-out chest, also known as 'funnel chest,' caused by abnormal cartilage growth.
Severity Varies: The indentation can be mild and unnoticeable or severe enough to compress the heart and lungs.
Symptom Spectrum: Severe cases can cause shortness of breath, fatigue, chest pain, and heart palpitations, especially during exercise.
Cause is Complex: While the exact cause is unknown, it is often linked to genetic factors and sometimes associated with connective tissue disorders like Marfan syndrome.
Treatment Options: Treatments range from observation for mild cases to non-surgical vacuum bell therapy and surgical correction (Nuss or Ravitch procedures) for more severe conditions.
Potential for Complications: Severe pectus excavatum can lead to cardiopulmonary issues and significant psychological distress, affecting body image and self-esteem.

What is Pectus Excavatum?

Derived from Latin for 'hollowed chest,' pectus excavatum is a congenital chest wall deformity where the breastbone (sternum) and attached rib cartilage develop abnormally, resulting in a concave or sunken appearance. This condition is the most common congenital chest wall abnormality and is often noticed at birth or during early childhood, though it may become more pronounced during adolescent growth spurts. The severity can vary significantly, from a barely noticeable dip to a deep depression that can impact internal organs.

Symptoms and Functional Impact

Symptoms associated with pectus excavatum can range from mild to severe and often worsen during periods of rapid growth, such as puberty. The most obvious sign is the visual indentation of the chest, which can be either symmetrical or asymmetrical. For many with mild cases, there are no physical symptoms, but for those with moderate to severe conditions, the inward-growing sternum can press on the heart and lungs, leading to complications.

Cardiopulmonary Symptoms: Compression can lead to shortness of breath, especially during exercise, fatigue, and decreased exercise tolerance. Some individuals may experience a rapid heartbeat (tachycardia), heart palpitations, or even heart murmurs as the heart is displaced and unable to pump blood efficiently.
Musculoskeletal and Other Issues: Poor posture, such as rounded shoulders and a hunched-forward stance, is common. Some patients report chest pain, and frequent respiratory infections have been linked to severe cases.
Psychosocial Effects: The visible nature of the condition can lead to significant psychological distress, affecting self-esteem and body image. This can cause social anxiety, emotional withdrawal, and avoidance of activities like swimming or changing for gym class.

Uncovering the Causes of a Sunken Chest

While the exact cause of pectus excavatum is not definitively known, research points to several contributing factors, with genetics playing a significant role. It is believed to stem from an excessive, uncoordinated growth of the costal cartilage.

Factors potentially contributing to the development of pectus excavatum include:

Genetic predisposition: A significant portion of individuals have a family history of chest wall deformities.
Associated disorders: Pectus excavatum is sometimes linked to genetic or connective tissue disorders such as Marfan syndrome, Noonan syndrome, Ehlers-Danlos syndrome, Poland syndrome, or Rickets.
Unknown origin: For many, the condition occurs sporadically without a known cause.

Diagnosis and Evaluation

Diagnosis typically begins with a physical exam. For further evaluation, especially before treatment, diagnostic tests may include a Chest CT Scan to calculate the Haller index, an Echocardiogram to assess heart function, Pulmonary Function Tests (PFTs) to measure lung capacity, and Exercise Stress Tests to evaluate cardiopulmonary performance during exertion.

Treatment Options for Pectus Excavatum

Treatment depends on the severity and symptoms; mild cases may only require observation. When intervention is needed due to physical symptoms or psychological distress, options include:


Treatment Method	Type	Description	Best For	Recovery Time
Observation	Non-Surgical	Regular check-ups to monitor progression; no active treatment.	Mild cases with minimal symptoms.	N/A
Vacuum Bell Therapy	Non-Surgical	A suction device worn on the chest to lift the sternum over time.	Younger patients with flexible chest walls and moderate defects.	1-2 years of consistent use.
Nuss Procedure	Minimally Invasive Surgery	A metal bar inserted under the sternum to push it outward, removed after 2-3 years.	Moderate to severe cases, generally in teens and young adults.	Days to weeks in the hospital, with activity restrictions for months.
Ravitch Procedure	Open Surgery	Involves removing deformed cartilage and repositioning the sternum.	Older patients or those with more complex or asymmetrical deformities.	Longer hospital stay and recovery than the Nuss procedure.
Cosmetic Fillers/Implants	Non-Surgical	Silicone implants or dermal fillers used to fill the depression.	Primarily for improving appearance in mild cases with no functional issues.	Minimal recovery; outpatient procedure.

This table provides general information; consult a healthcare professional for specific recommendations.

The Importance of Seeking Medical Advice

While many with a mild sunken chest live normal lives, evaluation by a healthcare professional is important to determine if the condition affects heart and lung function. A specialist can explain potential health implications and treatment options.

For additional information, you can visit a reputable medical institution's website, such as Johns Hopkins Medicine.

Conclusion

The medical term for when the middle of your chest goes in is pectus excavatum. This congenital deformity varies in severity and can impact physical health and self-confidence. Causes are not fully understood but involve genetic and developmental factors. Various diagnostic tools and treatments are available, allowing most individuals to achieve significant improvement. Consulting a qualified surgeon is the first step for effective management.

Frequently Asked Questions

Pectus excavatum can be dangerous if the chest depression is severe enough to press on the heart and lungs, potentially impairing their function, especially during activity. Mild cases are often primarily a cosmetic concern.

For younger patients with moderate, flexible pectus excavatum, non-surgical vacuum bell therapy can be effective. Severe cases typically require surgery for lasting correction.

Pectus excavatum is a sunken chest, while pectus carinatum ('pigeon chest') is when the breastbone and ribs protrude outward. They are opposite deformities.

It can become more pronounced during adolescent growth spurts. Symptoms related to organ compression may progress with age if untreated, though the physical deformity usually stabilizes in young adulthood.

Exercise cannot correct the bone deformity but can improve posture, strengthen chest muscles, and increase chest expansion. This may help manage symptoms and improve appearance in mild cases but is not a cure.

Yes, pectus excavatum has a known genetic component, with many individuals having a family history of the condition. It can also be associated with certain genetic syndromes.

Start with a pediatrician or primary care doctor. For severe cases or surgical consideration, consult a thoracic or pediatric surgeon specializing in chest wall deformities.