Funnel chest

Pectus excavatum

Funnel chest, also known as pectus excavatum, is a condition in which the breastbone and rib cage grow inwards. This creates a funnel-shaped hollow in the middle of the chest. Hence the name funnel chest.

Cause of funnel chest

Excessive growth of the costal cartilage is the cause of a funnel chest. Why this happens is not fully known. The hollow is formed because the breastbone is pushed inwards. There is an increased risk of a funnel chest in people whose relatives also have this condition and in people with connective tissue diseases such as Marfan syndrome or Ehlers-Danlos syndrome.

A funnel chest occurs in approximately one in 1000 people and affects boys four times more often than girls. This is more common than pigeon chest, in which the rib cage grows outwards.

The condition usually begins in childhood or is already present at birth. It can worsen during a period of rapid growth, for example during puberty. If the funnel chest is already present at a young age, the organs are better adapted to the altered shape of the rib cage.

Complaints of a funnel chest

Complaints as a result of a funnel chest vary from mild to severe. With mild abnormalities, the hollow is hardly noticeable. These people may have no complaints at all. In people with a severe funnel chest, the deformity is clearly visible. The space in the chest is therefore smaller than normal. They may experience problems such as:

  • Difficulty breathing.
  • Chest pain.
  • Fatigue.
  • Reduced strength and exercise capacity.
  • Shame or insecurity about appearance.

Treatment of a funnel chest

With a mild funnel chest, it is usually not necessary to intervene. In severe cases, an operation is sometimes needed. During this operation, an implant is placed in the chest to support it and improve the shape. Physiotherapy can be useful to improve breathing and increase muscle strength.

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