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Pectus Excavatum

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Pectus Excavatum Overview

With this deformity, several ribs and the sternum (breast plate) grow abnormally, producing a caved-in or sunken appearance in the chest. The chest curves inward rather than outward.

In severe cases, the chest has a deep dent and appears scooped out.

Pectus excavatum, sometimes referred to as funnel chest:

  • Is often apparent at birth, but may not develop or worsen until puberty.
  • Affects one in every 300 to 400 people.
  • Occurs more often in males than females.

Causes of pectus excavatum

Doctors donā€™t have a clear understanding about the causes of pectus excavatum.

The condition involves overgrowth of the rib cartilage at the junction with the breastbone ā€” also called the costochondral region ā€” and seems to have a hereditary component. About 40 percent of those with pectus excavatum have at least one family member with the defect.

Most cases of the birth defect do not have other conditions associated with them, but some disorders (scoliosis, rickets, and Marfan syndrome) include the sunken chest characteristic seen in pectus excavatum.


Contact Us

Contact the UPMC Esophageal and Lung Surgery Institute with questions or for more information.
Or, call the Thoracic and Foregut Surgery Division at 412-647-7555.

Pectus Excavatum Symptoms and Diagnosis

Most people do not experience symptoms with pectus excavatum, causing some to consider it only a cosmetic deformity. Depending on severity, pectus excavatum can cause compression of the heart and lungs, impairing cardiac and respiratory functions.

Symptoms of pectus excavatum

Some symptoms of this congenital chest wall defect include:

  • Shortness of breath
  • Fatigue
  • Chest pain
  • Tachycardia (abnormally rapid heart rate)
  • Decreased tolerance to physical exercise

Diagnosing pectus excavatum

A primary care doctor, along with a thoracic surgeon and pulmonology specialist, will conduct a complete physical and order a comprehensive panel of blood tests to confirm a diagnosis of pectus excavatum.

Depending on the severity of the defect and the results of the exams and blood work, the medical team may order a number of other tests, such as:

  • Echocardiogram (image of the heart)
  • Electrocardiogram (EKG)
  • Computerized tomography (CT) scan of the chest
  • MRI of the chest
  • X-ray of the chest
  • Genetic testing
  • Enzyme assays
  • Metabolic studies
  • Pulmonary (lung) function tests

Contact Us

Contact the UPMC Esophageal and Lung Surgery Institute with questions or for more information.
Or, call the Thoracic and Foregut Surgery Division at 412-647-7555.

Pectus Excavatum Treatment

Adults and children with pectus excavatum have a number of treatment options available at the UPMC Esophageal and Lung Surgery Institute.

Those with the mildest cases of deformity can benefit from physical therapy aimed at improving posture and appearance of the chest, avoiding surgery. People experiencing symptoms, or those with moderate to severe deformity, may need surgery.

Minimally invasive surgery ā€” Nuss procedure

At UPMC, our team of thoracic surgeons uses the minimally invasive Nuss procedure to treat pectus excavatum.

UPMC thoracic surgeons typically employ this video-assisted thoracoscopic surgery procedure when correcting pectus excavatum on adolescent and adult patients.

What to expect during the Nuss procedure

Using this innovative, minimal access technique:

  • The surgeon will insert a curved steel bar, called the Pectus Bar, under the breastbone (sternum) through two small incisions on either side of the chest.
  • The steel bar corrects the curvature of the chest.
  • The surgeon then affixes the bar to the ribs on each side.

Each person receives a steel bar that fits his or her individual chest curve.

The bar remains inside the chest for at least two years and is not visible from the outside. When it's time, the doctor will remove the bar in an outpatient surgical procedure.

Traditional open chest surgery

Surgeons typically use traditional surgery to correct pectus excavatum in adults whose symptoms have become severe, or whose deformity negatively impacts their desire to participate in social activities that may expose the chest area.

Compared to the Nuss procedure, open chest surgery comes at a greater risk and has a longer recovery time.


Contact Us

Contact the UPMC Esophageal and Lung Surgery Institute with questions or for more information.
Or, call the Thoracic and Foregut Surgery Division at 412-647-7555.

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