What should be noted for pectus excavatum?

Written by Zhang Zhi Gong
Cardiothoracic Surgery
Updated on November 25, 2024
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We know that behind the sternum of a normal person are the heart and lungs. Pectus excavatum is a deformity where this part of the sternum is pressed inward towards the spine. Such inward compression, as it occurs right against the bony spine, will directly squeeze the heart and in severe cases, can lead to insufficiency in the heart valve closure. Therefore, the most critical issue with pectus excavatum is the compression of the heart, which also compresses the lungs. Thus, 80% of children with pectus excavatum have lower exercise capacity compared to normal children, 60% may experience chest pain, and 40% have a significantly higher respiratory rate than normal children. Therefore, for patients with pectus excavatum, it is crucial to be cautious about common colds, as their respiratory and cardiac functions can be greatly affected if they catch a cold.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Can people with pectus excavatum join the military?

Theoretically, the current conscription system does not have strict restrictions on mild cases of pectus excavatum. However, obvious moderate or severe pectus excavatum, or sternums that are inwardly and backwardly concave, can significantly impact the function of both the heart and lungs by compressing them. This inward concavity can restrict the heart’s ability to fully expand, potentially causing complete deformation of the heart, or even prevent the heart’s valves from closing fully, leading to valve regurgitation. Such compromised cardiac and pulmonary functions are likely unable to withstand the physical demands experienced during military service. Therefore, for moderate and severe cases of pectus excavatum, we do not recommend enlisting in the military, although the current policy does not have clear restrictions on mild cases of pectus excavatum.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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What should be noted in daily life for people with funnel chest?

Since pectus excavatum is an inward and backward depression, such a depression may gradually become apparent even from a young age, especially worsening during adolescence. Therefore, children or patients with this condition should be aware of any significant lack of calcium or vitamin D. Of course, since pectus excavatum may also be somewhat related to familial genetic factors, it is important to check whether the child has any congenital heart diseases, Noonan syndrome, or connective tissue disorders. Since pectus excavatum causes an inward and backward indentation that compresses the heart and lungs, children with this condition may not be able to fully expand their lungs or completely relax their hearts. Consequently, these children tend to have a weaker constitution and may catch colds easily. Therefore, children with pectus excavatum should avoid crowded places, as their weaker constitution makes them more susceptible to colds, which can exacerbate their developmental issues, thus creating a vicious cycle.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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How to exercise the pectoral muscles with pectus excavatum?

How to exercise the pectoral muscles with pectus excavatum, we know that the indentation of pectus excavatum is concave inward and backward, that is, the front sternum in the middle of a person's chest compresses backward towards the spine. Exercising the pectoralis major muscle aims to lift the muscles on both sides of the sternum, but the attachment point of the pectoralis major actually pulls from the ribs outward and upward towards the humeral tuberosity of the arms. This type of lifting actually pulls the force of the ribs or a part of the sternum outward, and it cannot pull forward. Indeed, the forward force is the direction truly needed when correcting pectus excavatum. Therefore, patients with pectus excavatum can exercise the pectoralis major, do push-ups, and perform dumbbell fly exercises, which are all feasible. However, such exercise will only make the pectoral muscles thicker and the force is directed sideways, and it cannot effectively pull the downward and inward-concaved sternum forward. Therefore, although individuals with pectus excavatum can perform exercises like push-ups and dumbbell flies like normal individuals, these exercises should not be expected to significantly improve pectus excavatum. Moreover, current medical technology and trials have not found exercising the pectoralis major to have a substantial corrective effect on pectus excavatum.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Can funnel chest be cured?

In fact, many diseases cannot be completely cured, including the common cold, for which there is currently no way to completely eradicate it, meaning there isn't a medicine that, once taken, prevents one from ever catching a cold again. Of course, this has a lot to do with the mutations of the cold virus. However, pectus excavatum can be cured, and there are generally two methods of treatment for it: surgical and non-surgical. The surgical method is suitable for older patients with harder bones. Conservative treatment is appropriate for younger patients with more elastic rib cages, who can cooperate well, or whose family can supervise and support them through this non-surgical approach. Regardless, it is completely possible to cure pectus excavatum, and there are methods to do so.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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How is funnel chest formed?

Regarding the cause of pectus excavatum, there have historically been many hypotheses. For a while, medical experts believed that pectus excavatum was caused by the backward pulling of the diaphragm behind the sternum. Thus, for a time, surgeries abroad involved cutting the portion of the diaphragm behind the depressed area of the chest. Eventually, it was discovered that such cutting did not significantly benefit the treatment of pectus excavatum, and the results were not very conclusive. Therefore, this hypothesis was later debunked. To date, it is generally believed that the primary formation of pectus excavatum is somewhat related to genetic or hereditary factors. Of course, not all cases of pectus excavatum are due to parents having the condition; it might be present in the genes of ancestors and only manifest in the current generation or in this patient. Additionally, pectus excavatum could be associated with other diseases, such as connective tissue disorders. For example, some patients might have congenital diaphragmatic hernias, and after surgical repair, they could be prone to pneumothorax. Furthermore, some patients may suffer from pectus excavatum due to subglottic stenosis and underdeveloped bronchopulmonary structures, possibly triggered by respiratory factors. However, no matter the details, the formation of pectus excavatum is directly or indirectly related to congenital genes or heredity.