What are the Symptoms & Causes of Sunken Chest Surgery

What is Sunken Chest?

Sunken Chest is commonly referred to as Pectus excavatum. It means a situation whereby a person’s sternum is indented and cannot be flattened on the chest as it is supposed to be. This can make the chest look caved in or hollow, thus making the patient look sick and unwell, especially if they have skinnier arms as well.

Some key points:

• In most cases, symptoms may only appear slightly different and would present no complications.
• It may even affect the heart and lungs, causing difficult breathing or restriction of easy movement or any other form of exercise.
• It starts at birth and may worsen during the adolescent growth phase.
• The causes are not well known but it is genetically inherited, hence it may be passed from one generation to the other.
• Accepted by how serious it is — some individuals do not require any treatment, others may require surgery, such as the Nuss technique or the Ravitch technique.

Treatment of Sunken Chest

The pectus excavatum treatment depends on how bad it is and whether it is causing symptoms such as chest pain, difficulty in breathing or heart diseases.

Here’s a clear breakdown of Pectus excavatum repair:

1. No Treatment (Monitoring Only)

• If it is detected early and does not have signs, then doctors may just keep a track on such patients.
• Depending on the degree of chest wall deformity, the patient might be advised to follow some exercises for posture correction and chest muscle strengthening (although they do not alter the chest shape).

2. Physical Therapy and Exercises

• Aerobic exercises such as chest ones, breathing, the usage of pressing and strength exercises can help enhance the appearance and lung capacity to an extent.
• Examples are: yoga, deep breathing, body weight exercises such as push-ups and other lower back exercises that correct posture.

3. Vacuum Bell Therapy

• A non-surgical option for some people, especially children and teens.
• It employs the use of a suction cup present on the chest in that it pulls the breastbone outwards over the period.
• Needs regular daily use for months to years.

4. Surgical Treatments

If symptoms are well developed, for example if a patient experiences regular pain or difficulty to swallow food down the throat, the doctor may recommend for him or her to undergo surgery.

a. Nuss Procedure

• The most common surgery today.
• A curved metal bar is placed under the sternum by using two small side cuts.
• It inspires the sternum and pushes it in the normal position to the chest.
• Usually it takes about 2–4 years and then a particular bar is pulled out.

b. Ravitch Procedure

• An older, more invasive surgery.
• Consists of eradicating of problematic cartilage as well as rearrangement of the sternum.
• Occasionally, there is a temporary support bar, which is also used in some cases.

5. Other Supportive Treatments

• Psychological advice if the appearance of the chest disturbs the patient.
• Cardiology and pulmonary examinations in case of heart and lung diseases.

Symptoms of Sunken Chest

Below are some of the signs or features of sunken chest (pectus excavatum):

1. Physical Appearance

• Appears to have hollow chest or chest concavity.
• Often more noticeable during teen growth.
• At other occasions the ribs may open outwards a little bit.

2. Breathing Problems

• Sore throat and /or hoarseness, and in occasions shortness of breath that occurs when one is engaging in activities that require the use of the muscles and /or lungs.
• Subconsciously, one is unable to take a deep, full breath of air.

3. Chest Pain

• Aching or sharp chest pain.
• Sometimes, the chest pain is as a result of pressure on the ribs or the muscles of the chest wall rather than the heart.

4. Heart Issues

• Fast heartbeat (palpitations).
• It had been described to feel like the hearts missing a beat or pulse.
• Occasionally, in the severe form it will get to the extent of influencing the efficiency of the heart in pumping blood.

5. Fatigue

• Exhaustion after a certain level of physical activity or during normal daily activities.

6. Emotional and Psychological Effects

• Self-consciousness about appearance.
• Low self-esteem or social anxiety, especially in teenagers.

Causes of Sunken Chest

If the cause of sunken chest (pectus excavatum) were known precisely, it may be easily corrected as many specialists assume it has something to do with the cartilage that connects the ribs and the breast bone. Here's a breakdown:

Main Causes and Risk Factors:

Genetics (Family History)

• More prevalent in certain age groups such as the elderly and the young; also hereditary since who acquires it from a parent or a sibling.

Abnormal Rib and Cartilage Growth

• It is another condition in the development of cartilage where some of the ribs are produced in large size or develop extra cartilages that connect them to the sternum.
• This pulls the sternum inward while the lower part of the row falls, causing the chest to sink.

Connective Tissue Disorders

• Genetic disorders such as Marfan syndrome, Ehler’s Danlos syndrome, and Noonan syndrome are some of the causes of pectus excavatum.
• These diseases are known to impair the body’s collagen and other connective tissues.

Other Congenital Conditions

• It can be accompanied by other spinal diseases such as scoliosis or other deformations of the chest wall.

Idiopathic (Unknown)

• Sometimes, no specific cause is envisaged since the phenomenon happens during development.

Best Doctors for Sunken Chest Surgery

• Dr. Parveen Yadav
• Dr. Harsh Vardhan Puri
• Dr. Udgeath Dhir
• Dr. Pawan Gupta

Top Hospitals for (Pectus Excauatum) Sunken Chest Surgery

• Artemis Hospital, Gurgaon
• Medanta-The Medicity, Gurgaon
• Fortis Memorial Research Institute, Gurgaon
• Max Hospital, Saket

Pectus Excavatum Diagnosis

Pectus excavatum diagnosis is rather easy, primarily, since it is mainly a congenital defect apparent at early stages of the life of an individual. It’s in this way that doctors usually determine it:

1. Physical Examination

• Also, the degree to which the chest is sunken has to be determined by the doctor.
• It ensures for flaring of the ribs, postural abnormalities, and whether the chest expands during breathing normally.

2. Patient History

They’ll ask about:

• Symptoms (like chest pain, shortness of breath, tiredness).
• Hereditary (as we have seen it may well be hereditary).
• Whether the chest deformity was first observed and whether the deformity has progressed to the next level.

3. Imaging Tests

To observe how the chest impacts the heart and lung:
Chest X-ray    

• Shows the depth of the sunken chest.

CT Scan (Computed Tomography)

• Gives a detailed 3D image.
• Measuring something named as Haller Index.
• Ratio of chest width to depth.
• It is customary to assume that if the index exceeds the number 3.25, then it is a severe condition.

MRI (Magnetic Resonance Imaging)

• In some cases, these may be employed to study the heart and lungs in detail without the use of radiation.

4. Heart and Lung Tests

If symptoms are serious:

Echocardiogram

• An echocardiographic examination in order to qualify for heart compression.

Pulmonary Function Test (PFT)

• An assessment parameter that aims at establishing the efficiency of the lungs.

Exercise Stress Test

• Tests heart and lung function during physical activity.

5. Other Evaluations (if needed)

• When there is a suspicion of a connective tissue disease, DNA analysis should be conducted as an investigation (Marfan syndrome for example).
• Have routine examination to check if the convene has scoliosis or any other skeletal problems.

Sunken Chest Facts and Solutions

Sunken Chest: Fast Facts

• Medical Name: Pectus Excavatum
• Appearance: There is a sunken sternum, or sunken chest as it is commonly referred as due to the inward curve in the chest area.
• Common in: Boys more than girls (about 3–5 times more common).
• When it may occur: Generally detected at infancy or during adolescence.

Causes:

• Abnormal growth of chest cartilage.
• Often associated with some genetic or connective tissue disorders such as Marfan syndrome.

Symptoms:

• Chest looks hollow or dented.
• Shortness of breath.
• Chest pain.
• Tiredness with exercise.
• Low self-esteem due to chest appearance.

Severity:

• Cosmetic: This only affects the way the tumor appears but does not mean it’s dangerous; often doesn’t require an operation.
• Serious (heart and lung) → may require surgery.

Solutions for Sunken Chest

1. For Mild Cases

• Posture correction exercises (like wall stands and yoga).
• Push-ups and pull-ups, pull-downs or lat pull downs.
• Balancing exercises of the upper body, particularly those that help expand the lungs.
• Vacuum bell therapy – yet another non-surgical procedure with the use of a vacuum.

2. For Moderate to Severe Cases

Nuss Procedure:

• Placing an arc of a metal as in-run to press against chest.
• Minimally invasive with small scars.

Ravitch Procedure:

• Operative exploration and reconstruction of the chest.
• Better for very stiff or uneven chests.

3. Emotional Support

• Support groups or counselling in case of lowered self-esteem.
• Most of the patients appear to be much more self-confident after the treatment.