Pectus Excavatum: Diagnosis and Treatment - Mayo Clinic

Diagnosis

Physical Exam: Initial diagnosis starts with a chest examination by a healthcare professional.
Chest X-ray: Identifies the dip in the breastbone and any heart displacement.
CT Scan or MRI: Assesses severity and checks for compression of the heart or lungs.
Electrocardiogram (ECG): Evaluates heart rhythm and electrical signals.
Echocardiogram: Provides real-time images of heart function and checks for any impact on heart function.
Lung Function Tests: Measures lung capacity and airflow.
Exercise Function Test: Monitors heart and lung performance during physical activity.

Physical Therapy: Enhances posture and chest expansion for mild cases.
Sternal Suction: Used mainly in children and young teens to pull the breastbone forward over several months.

Nuss Procedure:
- Minimally invasive.
- Involves placing and then flipping a curved metal bar under the breastbone.
- Bars are removed after 2-3 years.
Ravitch Technique:
- Less common, involves a larger incision and removal of deformed cartilage.
- Uses surgical hardware to fix the breastbone, later removed after a year or more.

Cosmetic Treatments: Focus on improving chest appearance using dermal fillers or silicone implants for mild cases.

Counseling and support groups can assist children and teens in coping with the cosmetic and psychological effects of the condition.

Prepare a list of symptoms, past health issues, family health history, and current medications.
Consider what questions to ask regarding available treatments.

Impact on Quality of Life: Surgical and non-surgical treatments can greatly improve symptoms and quality of life for individuals with pectus excavatum.
Surgery Outcomes: Most surgeries have favorable outcomes leading to improved chest appearance and function.

References: Mayo Clinic, Nelson Textbook of Pediatrics, Current Surgical Therapy.

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