Why do I have a big indent in my chest? A comprehensive guide to pectus excavatum

September 27, 2025 •

4 min read

Pectus excavatum, the most common congenital chest wall deformity, is frequently the reason behind a chest indentation. If you are asking Why do I have a big indent in my chest?, it is important to understand the potential causes, which range from genetic factors to developmental anomalies.

Quick Summary

An indent in the chest is most often caused by pectus excavatum, a common congenital condition where the breastbone is sunken inward due to abnormal cartilage growth. It can be a mild cosmetic concern or severe enough to affect heart and lung function, warranting medical evaluation.

Key Points

Main Cause: A chest indent is most often caused by pectus excavatum, a congenital condition where the breastbone is sunken inward due to abnormal cartilage growth.
Varying Severity: The indentation can be mild and cosmetic or severe enough to compress internal organs, potentially affecting heart and lung function.
Genetic Factors: There is often a genetic link, as pectus excavatum frequently runs in families.
Puberty Impact: The condition can become more pronounced during adolescent growth spurts.
Associated Symptoms: Severe cases can cause chest pain, fatigue, shortness of breath, and heart palpitations.
Treatment Options: Treatments range from non-surgical vacuum bell therapy and physical therapy for mild cases to surgical repair (Nuss or Ravitch procedures) for more severe conditions.
Professional Evaluation: Any significant chest indent warrants a medical evaluation to assess severity and discuss potential health impacts and treatment.

What is Pectus Excavatum?

Pectus excavatum, also known as "funnel chest" or "sunken chest," is a condition where the breastbone (sternum) and the attached ribs grow inward, creating a visible depression in the center of the chest. This is a congenital condition, meaning it is present at birth, although it may not become noticeable or more pronounced until the rapid growth spurt of adolescence. While many cases are mild and present no physical symptoms, more severe cases can place pressure on the heart and lungs, potentially impacting their function.

What Causes a Sunken Chest?

The exact cause of pectus excavatum is not fully understood, but it is believed to be related to the abnormal growth of the costal cartilage that connects the ribs to the breastbone. This overgrowth pushes the sternum inward over time. Research suggests that a significant genetic component is involved, as the condition often runs in families. Pectus excavatum is also associated with certain genetic and connective tissue disorders, including:

Marfan syndrome
Ehlers-Danlos syndrome
Osteogenesis imperfecta
Noonan syndrome
Scoliosis

Although it is present from birth, the inward growth can become more severe during periods of rapid growth, such as during puberty. This is why many individuals find their chest indent becomes more prominent during their teenage years.

Is an Indent in the Chest Serious?

The seriousness of a chest indentation largely depends on its severity. For many individuals, pectus excavatum is a mild cosmetic concern that does not cause any health issues. However, in more severe cases, the sunken breastbone can compress the heart and lungs. This compression can lead to a range of potential health problems, including:

Reduced Lung Capacity: The inward pressure can limit the amount of space available for the lungs to expand fully, potentially leading to shortness of breath, especially during exercise.
Cardiovascular Issues: The heart may be displaced or squeezed, which can impact its ability to pump blood efficiently. This can result in heart palpitations or a rapid heartbeat.
Decreased Exercise Tolerance: A combination of reduced lung capacity and heart function can lead to decreased stamina and fatigue during physical activity.
Emotional and Psychological Impact: Even with mild cases, the visual appearance of a sunken chest can lead to self-esteem issues, body image concerns, and social anxiety, particularly for adolescents. Counseling or support groups can be beneficial in these situations.

Symptoms Associated with Pectus Excavatum

While a visible indentation is the primary symptom, moderate to severe cases can be accompanied by a variety of physical symptoms. It is important to monitor for these additional signs:

Chest pain or discomfort
Fatigue or decreased stamina during physical activity
Rapid or irregular heartbeat (palpitations)
Shortness of breath, especially when exercising
Frequent respiratory infections
Wheezing or coughing
Heart murmur (detected by a doctor)
Dizziness or fainting

Diagnosis and When to See a Doctor

Diagnosing pectus excavatum typically involves a physical examination by a healthcare provider. The doctor will assess the severity of the indentation and may order additional tests to evaluate its effect on your heart and lungs. You should see a healthcare professional if the indentation is prominent, if it appears to be worsening, or if you experience any of the associated symptoms. Diagnostic tests may include:

Chest X-ray: Provides a visual image of the chest and can show if the heart is displaced.
CT scan or MRI: These advanced imaging techniques provide more detailed cross-sectional images to determine the severity of the compression on the heart and lungs.
Electrocardiogram (EKG): Records the heart's electrical activity to check for any abnormal rhythms.
Echocardiogram: An ultrasound of the heart that provides real-time images of its structure and function.
Pulmonary Function Tests: Measure lung capacity and how quickly air can be moved in and out of the lungs.
Exercise Stress Test: Monitors heart and lung function during physical exertion.

Treatment Options for a Chest Indentation

Treatment for pectus excavatum varies depending on its severity and the presence of any symptoms. Mild cases may not require any treatment, but monitoring is often recommended. For moderate to severe cases, there are several options available. Here is a comparison of common treatment approaches:


Feature	Non-Surgical Treatments	Surgical Treatments
Best for	Mild cases or younger patients with flexible chests.	Moderate to severe cases causing physical symptoms or significant cosmetic concerns.
Methods	Vacuum Bell Therapy: A suction cup device is used daily to gently pull the sternum forward over time.	Nuss Procedure: A minimally invasive procedure where a curved metal bar is placed under the sternum to push it outward. The bar is removed later.
	Physical Therapy: Exercises focusing on improving posture and strengthening core muscles can help manage some symptoms.	Ravitch Technique: An open surgery where deformed cartilage is removed and the breastbone is repositioned.
Goal	Corrects the deformity without invasive surgery.	Corrects the deformity to relieve pressure on internal organs and improve appearance.
Side Effects	Temporary discomfort, bruising, or skin irritation.	Post-operative pain, risk of complications, and potential for recurrence.
Timeframe	1-2 years of consistent daily use.	A single procedure, with recovery taking weeks to months and bar removal after 2-3 years.

For some adults with mild cosmetic concerns, a silicone implant may be used to fill the indent, providing a purely cosmetic solution.

Conclusion: Understanding and Addressing Your Chest Indent

Discovering a significant indent in your chest can be worrying, but it is often a sign of pectus excavatum, a manageable and common condition. The key to addressing a chest indent is proper evaluation by a healthcare provider, who can determine the severity and potential health implications. While many cases are cosmetic, severe instances can affect heart and lung function and should not be ignored. Whether through a non-surgical approach like vacuum bell therapy or a surgical procedure, effective treatments are available to alleviate symptoms and improve quality of life. For further authoritative information, consult resources like the Cleveland Clinic on Pectus Excavatum or a specialist in chest wall deformities.

Frequently Asked Questions

A big indent in your chest is most likely a condition called pectus excavatum, also known as "sunken chest" or "funnel chest." It is a congenital deformity caused by the abnormal growth of the cartilage that connects your ribs to your breastbone, pushing the sternum inward.

Yes, in moderate to severe cases, a sunken chest can put pressure on the heart and lungs. This can potentially lead to symptoms like reduced exercise tolerance, shortness of breath, heart palpitations, and chest pain.

For many individuals, the condition becomes more noticeable and can worsen during adolescent growth spurts. While the inward growth typically stabilizes after puberty, monitoring the progression is often recommended.

Yes, non-surgical options exist, particularly for younger patients with mild cases. These include vacuum bell therapy, which uses suction to lift the breastbone over time, and physical therapy to improve posture and muscle strength.

Pectus excavatum is a condition where the breastbone is sunken inward, creating a depression. Pectus carinatum, by contrast, is a chest wall deformity where the breastbone protrudes outward, sometimes called "pigeon chest."

While exercise cannot correct the underlying skeletal deformity, physical therapy and targeted exercises can improve posture and strengthen the chest muscles. This can sometimes make the indentation less noticeable and may improve some related symptoms.

You should see a doctor if your chest indentation is significant, appears to be worsening, or is accompanied by physical symptoms such as shortness of breath, chest pain, or a rapid heart rate. A professional can properly diagnose the condition and determine if treatment is necessary.