Pectus Excavatum: What a Sunken Breastbone Means for Your Heart, Lungs, and Confidence
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: September 2026
Pectus Excavatum: What a Sunken Breastbone Means for Your Heart, Lungs, and Confidence
TL;DR
Pectus excavatum — sometimes called funnel chest — is a condition in which the breastbone is sunken into the chest, creating a dent or dip that is often visible shortly after birth. It is the most common congenital chest wall birth defect, affecting about 1 in 400 babies. For many people the only symptom is a slight dip, but the breastbone can compress the lungs and heart, causing chest pain, shortness of breath, a fast or pounding heart, fainting, and less endurance over time. Symptoms often worsen during the teenage growth spurt. Risk rises with a family history or connective tissue and genetic conditions such as Marfan, Ehlers-Danlos, osteogenesis imperfecta, Noonan, or Turner syndrome. Treatment ranges from physical therapy and sternal suction devices for mild cases to surgery — the Nuss procedure or the Ravitch technique — for moderate to severe cases, and most people who have surgery are happy with the change in how their chest looks.
Quick Answer
What is pectus excavatum? A condition in which the breastbone is sunken into the chest, creating a dent or dip; it also goes by the name funnel chest and affects about 1 in 400 babies.
What are the symptoms? Often only a slight dip in the chest, but it can cause a fast-beating or pounding heart, chest pain, shortness of breath or extreme tiredness during activity, fainting or dizziness, frequent upper airway infections, and stress about appearance.
What causes it? The exact cause is unknown; experts believe irregular cartilage development connects the breastbone to the ribs, and genes may play a role.
Who is at higher risk? People with a family history of pectus excavatum, or with connective tissue conditions (Marfan, Ehlers-Danlos, osteogenesis imperfecta) or genetic conditions (Noonan, Turner syndrome).
How is it diagnosed? A chest exam may be enough; X-rays, CT scans or MRI, electrocardiogram, echocardiogram, lung function tests, and exercise function tests check the heart and lungs.
How is it treated? Physical therapy and sternal suction for mild cases; the Nuss procedure (curved metal bar under the breastbone) or the Ravitch technique (cartilage removal and repositioning) for moderate to severe cases; silicone implants or dermal fillers for appearance-only concerns.
When should you see a doctor? If you or your child has any symptoms — especially if symptoms worsen or the chest keeps becoming more sunken.
What Is Pectus Excavatum?
Pectus excavatum is a condition in which the breastbone is sunken into the chest. The sunken breastbone often can be seen shortly after birth. If the breastbone sinks a lot over time, the center of the chest may look like it has been scooped out, leaving a deep dent or dip. But many people with the condition just have a slight dip in the breastbone.
This condition also is known as funnel chest. It can affect much more than the look of the chest. It can cause symptoms such as shortness of breath, chest pain, and a fast-beating, fluttering, or pounding heart. The symptoms tend to become worse during the teenage growth spurt.
The exact cause isn't clear. When the condition is serious, it can affect how well the heart and lungs work over time. But even mild pectus excavatum that causes only a slight dip can make children feel self-conscious about their bodies.
Pectus excavatum sinks the breastbone (sternum) inward, which in severe cases can compress the lungs and push the heart to the left. Severity ranges from a mild dip with no symptoms to a scooped-out chest with reduced lung expansion and exercise endurance. About 1 in 400 babies are born with it, making it the most common congenital chest wall birth defect.
What Are the Symptoms?
For many people with pectus excavatum, the only symptom is a slight dip in their chests. In some children, the dip becomes deeper during early puberty. It can keep getting deeper into adulthood.
In people with pectus excavatum, the breastbone may compress the lungs and heart. When that happens, symptoms can include:
A fast-beating, fluttering, or pounding heart
Chest pain
Loss of endurance that becomes worse over time
Shortness of breath or extreme tiredness during physical activity
A high-pitched whistling sound made while breathing, triggered by exercise
Fainting or dizziness
Frequent infections of the upper airway
Stress and concern about how the chest looks
When to See a Doctor
See a healthcare professional if you or your child has any symptoms of pectus excavatum. This is especially important if the symptoms become worse or if the chest keeps becoming more sunken.
What Causes Pectus Excavatum?
The exact cause of pectus excavatum isn't known. Some experts think it has to do with connective tissue called cartilage — the tissue that connects the breastbone to the ribs may develop in an irregular way. Genes may play a role in this process.
Who Is at Higher Risk?
| Risk Factor | Detail | |---|---| | Family history of pectus excavatum | The condition can run in families, pointing to a genetic component | | Connective tissue conditions | Living with Marfan syndrome, Ehlers-Danlos syndrome, or osteogenesis imperfecta raises the risk | | Genetic conditions | Noonan syndrome or Turner syndrome is associated with higher risk | | Unknown factors | Because the exact cause isn't known, some cases appear with no identifiable risk factor |
Risk is highest with a family history of pectus excavatum or with connective tissue conditions (Marfan, Ehlers-Danlos, osteogenesis imperfecta) and genetic conditions (Noonan, Turner syndrome). Symptoms such as a pounding heart, chest pain, breathlessness during activity, or fainting suggest the breastbone is pressing on the heart or lungs and warrant a healthcare visit.
What Are the Possible Complications?
Sometimes, pectus excavatum can lead to serious health issues called complications. The complications can affect the heart, lungs, and mental health.
Heart and Lung Trouble
If the depth of the dent in the breastbone is serious, the lungs may not have enough room to fully expand. The dent also can squeeze the heart. The heart may be pushed to the left and may not pump blood as well as it should. This can cause symptoms such as being less able to exercise, shortness of breath, a fast heart rate, and chest pain or pressure.
Self-Image Concerns
Many people who have pectus excavatum also tend to have a hunched-forward posture. Their lower ribs may flare out and their shoulders may be rounded. Many feel stress over how their bodies look. They may stay away from activities where the chest can be seen, such as swimming. They also might wear clothes that hide the dip in the chest.
How Is Pectus Excavatum Diagnosed?
Diagnosis involves the steps a healthcare professional takes to find out if you or your child has pectus excavatum. The professional starts with an exam of the chest, which may be enough to diagnose the condition. Other tests can check for health issues linked with pectus excavatum that affect the heart and lungs.
| Test | What It Shows | |---|---| | Chest exam | The starting point; often enough to diagnose the condition on its own | | Chest X-ray | Makes images of the dip in the breastbone; often shows the heart pushed into the left side of the chest; takes only a few minutes | | CT scan or MRI | Helps find out how serious the pectus excavatum is and shows whether the heart or lungs are being compressed | | Electrocardiogram (ECG or EKG) | Shows whether the heart's rhythm is regular and whether the electrical signals that control the heartbeat are timed properly; done with sticky patches called electrodes on the chest connected by wires to a computer | | Echocardiogram | Gives real-time images of how well the heart and heart valves are working using sound waves from a wand pressed against the chest; shows whether the chest wall may be affecting heart function and blood flow | | Lung function tests | Measure the amount of air the lungs can hold and how quickly the lungs can push out air | | Exercise function test | Tracks how well the heart and lungs work during exercise, usually on a bike or treadmill |
How Is Pectus Excavatum Treated?
Pectus excavatum treatments include physical therapy, medical devices, and surgery. Surgery is mainly for people who have moderate to severe symptoms. People who have mild symptoms may get better with other treatments.
Some treatments aim only to improve how the chest looks. For example, dermal fillers or silicone implants can help fill in the sunken part of the chest.
After a chest exam and imaging and heart tests establish severity, mild cases may be managed with physical therapy or sternal suction. Moderate to severe cases are treated with the Nuss procedure (the more common surgery) or the Ravitch technique, and appearance-only concerns can be addressed with cosmetic options.
Non-Surgical Options
Treatments that don't involve surgery may help some people with mild pectus excavatum.
| Therapy | How It Works | |---|---| | Physical therapy | Some exercises may improve posture and increase the degree to which the chest can expand | | Sternal suction | A cup- or bell-shaped device is placed on the breastbone and uses suction to gently pull the breastbone forward; for children and younger teens, the device is used for one or more hours a day for about 12 to 15 months |
Surgical Options
Surgery to repair pectus excavatum can ease symptoms and improve how the chest looks. Surgery tends to be a treatment choice for teens and young adults. Surgery may be right for some older people too. Two types of surgeries can repair pectus excavatum.
| Surgery | How It Works | Bar or Hardware Removal | |---|---|---| | Nuss procedure (more common) | Minimally invasive: small cuts on each side of the chest; long-handled tools and a tiny camera pass through the cuts; a curved metal bar is threaded under the sunken breastbone and rotated to raise it into a more typical position; often more than one bar is used | The bars are removed after about two or three years | | Ravitch technique (older, done much less often) | A larger cut is made down the center of the chest; the deformed cartilage that attaches the ribs to the lower breastbone is removed; the breastbone is fixed into a more regular position with surgical hardware such as a metal strut or mesh supports | The supports are removed after a year or more |
Most people who have surgery to correct pectus excavatum are happy with the change in how their chests look. Studies found that to be true no matter which of the two surgeries people had.
Pain Management After Surgery
Surgeons have many ways to help control pain from surgery. During surgery, they can freeze nerves to block pain afterward. This is called cryoablation, and it can help with recovery. The pain-relieving effects may last for weeks.
Cosmetic-Only Options
Some treatments aim to improve only the appearance of the chest. These cosmetic treatments are mainly for people who have mild pectus excavatum without meaningful symptoms. A healthcare professional can place a silicone implant in the chest to fill in the sunken area, or shots of certain dermal fillers may help fill in the area.
Coping and Support
Most children and teens just want to fit in and look like their peers. This can be very hard for young people who have pectus excavatum. Counseling may help some kids and teens feel better about themselves. Online support groups and forums also are available, and these can help connect kids and teens with other young people who have pectus excavatum.
How to Prepare for Your Appointment
If you or your child has pectus excavatum, you might first talk about the condition with your family healthcare professional. You might then be referred to a doctor who does pediatric or chest surgery.
What You Can Do
Write a list that includes detailed descriptions of your symptoms or your child's symptoms, information about past health problems, information about common health conditions in your family, all the medicines and supplements you or your child takes, and questions you want to ask the healthcare team — including what treatments are available.
What to Expect From Your Doctor
| Questions Your Healthcare Professional May Ask | |---| | When did these symptoms start? | | Have they become worse recently? | | Has anyone else in your family had pectus excavatum? |
Conclusion
Pectus excavatum is easy to underestimate because it begins as something purely visual — a dip in the chest that many people and families dismiss as a cosmetic quirk. The medical reality is more layered. About 1 in 400 babies are born with a chest wall that forms concave, and while many live with only a slight dip, a deepening dent can compress the lungs, push the heart to the left, and quietly erode exercise endurance, breathing comfort, and confidence — often just as a teenager hits the growth spurt where symptoms tend to worsen.
The management pathway is equally layered. A chest exam may be all that's needed to diagnose the condition, with X-rays, CT or MRI, heart rhythm tests, and lung function tests quantifying how much pressure the dent puts on the organs. Mild cases can respond to physical therapy or sternal suction over 12 to 15 months. Moderate to severe cases have two proven surgeries — the minimally invasive Nuss procedure and the more involved Ravitch technique — and studies show most people are happy with the outcome of either. For appearance-only concerns, silicone implants and dermal fillers offer a lower-commitment route.
The takeaway for parents and patients: a deepening dent or new symptoms like breathlessness, a pounding heart, or fainting are the signals to act, not to wait.
Your next steps: If you or your child has a visible chest dip, any breathing or heart symptoms during activity, or a family history of the condition, start with your family healthcare professional and ask about a referral for a full evaluation. If self-image is weighing on your child, ask about counseling and support groups alongside any medical plan.
FAQ
Is pectus excavatum dangerous?
For many people it is not dangerous, and the only symptom is a slight dip in the chest. But if the dent is serious, it can compress the lungs and squeeze the heart, pushing it to the left and impairing how well it pumps blood. That can cause shortness of breath, chest pain, a fast heart rate, and reduced ability to exercise over time.
What does pectus excavatum look like?
The breastbone is sunken into the chest, creating a dip or dent that is often visible shortly after birth. If it sinks a lot over time, the center of the chest can look scooped out. Associated features can include a hunched-forward posture, flared lower ribs, and rounded shoulders.
Why is pectus excavatum called funnel chest?
"Funnel chest" is the descriptive common name for the condition, referring to the funnel-like inward dip of the breastbone. Both names describe the same condition.
At what age does pectus excavatum usually appear or worsen?
The dip can be seen shortly after birth. In some children it becomes deeper during early puberty, can keep deepening into adulthood, and symptoms tend to become worse during the teenage growth spurt.
Can pectus excavatum be fixed without surgery?
Mild cases may improve with non-surgical treatments. Physical therapy exercises can improve posture and chest expansion, and sternal suction — a cup- or bell-shaped device worn for one or more hours a day for about 12 to 15 months — gently pulls the breastbone forward in children and younger teens.
What is the Nuss procedure?
The Nuss procedure is the more common surgery for pectus excavatum. It is minimally invasive: the surgeon makes small cuts on each side of the chest, threads a curved metal bar under the sunken breastbone, and rotates the bar to raise the breastbone into a more typical position. The bars are removed after about two or three years.
How long does recovery take after pectus excavatum surgery?
During surgery, nerves can be frozen (cryoablation) to block post-surgery pain, with effects lasting for weeks. Most people who have surgery are happy with the change in how their chest looks, regardless of whether they had the Nuss procedure or the Ravitch technique.
Is pectus excavatum genetic?
The exact cause isn't known, but genes may play a role. Risk is higher with a family history of the condition, and with connective tissue conditions such as Marfan, Ehlers-Danlos, and osteogenesis imperfecta, or genetic conditions such as Noonan and Turner syndrome.
References
Clinical facts drawn exclusively from the referenced sources.
Health information, not medical advice. This article is for general education and is not a substitute for professional diagnosis or treatment. Always consult a qualified healthcare provider about your own health, and seek emergency care for urgent symptoms.
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