Mild Pectus Excavatum: Concerns and Treatment Options - Pulmonology

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Mild pectus excavatum


Hello doctor, I have mild pectus excavatum and have often felt that my athletic ability is not on par with my peers since childhood.
A few days ago, I visited the thoracic surgery department at a major hospital.
Upon examination, the doctor asked me to raise my arms and stated that my condition is mild and does not require surgery.
I then asked the doctor if this condition could worsen over time and if it truly has no impact on my physical performance.
The doctor reassured me that it would not affect me and sent me on my way.
Later, I underwent pulmonary function tests in the pulmonology department and an electrocardiogram and echocardiogram in the cardiology department, all of which returned normal results, except for mitral valve prolapse.
The cardiologist mentioned that if the issue is not related to the mitral valve, it might be associated with the width of my chest due to the pectus excavatum.
Therefore, I am very concerned about whether not having surgery is indeed the better option.
Will my condition worsen over time, or will I eventually need surgery?

Xiansheng, 20~29 year old female. Ask Date: 2022/01/29

Dr. Wang Lanfeng reply Pulmonology


Hello: Generally speaking, mild pectus excavatum does not affect lung function unless it has significantly impacted lung function or there are aesthetic concerns that require intervention.
Based on your description, you only have a mild case of pectus excavatum, and your pulmonary function tests are normal.
In that case, your pectus excavatum should not require any treatment.
Thank you.

Reply Date: 2022/01/29

More Info


Mild pectus excavatum, commonly referred to as funnel chest, is a condition where the breastbone (sternum) is sunken into the chest. This deformity can vary in severity, and in many cases, individuals with mild forms may not experience significant physical limitations or health issues. Your concerns about the potential for worsening of the condition and its impact on your athletic performance are valid, especially since you have noted a perceived decrease in your exercise capacity compared to your peers.

From a medical standpoint, mild pectus excavatum often does not require surgical intervention. The decision to pursue surgery typically depends on the severity of the deformity, the presence of any associated symptoms, and the impact on the individual's quality of life. In your case, since the thoracic surgeon assessed your condition as mild and indicated that surgery was unnecessary, it suggests that your current state is not likely to progress to a point where it would cause significant health issues.

It's reassuring that your pulmonary function tests and cardiac evaluations returned normal results. This indicates that, at least at this time, your lung capacity and heart function are not adversely affected by the pectus excavatum. The mention of mitral valve prolapse is noteworthy, as it can sometimes be associated with connective tissue disorders, which may also have implications for your overall health. However, it is essential to differentiate whether the valve issue is directly related to your chest deformity or if it stands alone as a separate concern.

Regarding your worries about the condition worsening, it is generally understood that mild pectus excavatum tends to remain stable over time, especially if there are no significant symptoms or functional impairments. However, it is crucial to monitor your condition regularly, particularly if you notice changes in your physical capabilities or if you start experiencing symptoms such as chest pain, shortness of breath, or exercise intolerance.

If you are still concerned about the potential for your pectus excavatum to worsen or if you feel that it is impacting your quality of life, you might consider seeking a second opinion from another thoracic surgeon or a specialist in pectus deformities. They can provide further insights and discuss potential treatment options, including non-surgical approaches like physical therapy or bracing, which may help improve your posture and overall chest appearance.

In summary, while your current assessment indicates that surgery is not necessary, it is essential to maintain open communication with your healthcare providers about any changes in your condition. Regular follow-ups can help ensure that any potential issues are addressed promptly. If you continue to have concerns about your exercise capacity or the implications of your pectus excavatum on your overall health, do not hesitate to advocate for further evaluation or treatment options. Your health and well-being are paramount, and it is important to feel confident in the care you are receiving.

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