Sometimes more than a cosmetic concern, pectus abnormalities can impair health. They can also signal an underlying condition, such as Marfan or Loeys-Dietz syndrome. Pectus carinatum and excavatum appear in the systemic score, a selective array of features used to evaluate these connective tissue disorders. Here is the lowdown on pectus problems
Pectus deformities are abnormalities that relate to the shape of a person’s chest wall. They are a feature of Marfan syndrome and some other connective tissue disorders but can happen unrelated to these conditions. This might be the first clue for a doctor to begin investigating a diagnosis of Marfan syndrome.
Often emerging during the formative, sensitive teenage years, chest deformities vary in aesthetic and medical severity. They are not always a cosmetic concern but can sometimes impair heart & lung function. They can also be a first clue to the existence of Marfan syndrome.
The problem often becomes more pronounced during adolescence and periods of rapid growth
Most pectus deformities are mild and do not interfere with daily activity. However, a small proportion of deformities are severe and can cause both psychological and physiological effects.
Psychological effects can include:
- issues with self esteem
- depression
- withdrawal from activities like dancing, swimming that could ‘expose’ the chest
- avoidance of social situations like sleep-overs, trips to the beach.
- this often coincides with puberty and teenage years when formation of strong friendship bonds is so important.
A very small minority of people with a severe pectus deformity can experience physiological effects due to the compression of their heart or lungs. Physiological effects can include:
- breathlessness on exercise or with minimal exertion
- difficulties swallowing due to pressure on the oesophagus
- heart rhythm disturbances or blackouts due to compression of major blood vessels or the pumping chambers of the heart.
Here is Thoracic Surgeon Joel Dunning discussing pectus deformities and the landscape of care: Watch Now
Treatment Pathways
We are collaborated with the wonderful charity Pectus Matters in 2024 on a webinar in which patient advocates for pectus surgery shared their story and surgeon Simon Kendall discussed the current landscape for care how to navigate treatment.
Here is a link to the webinar.
In 2025 we invited Thoracic Surgeon Joel Dunning to discuss updated treatment options for pectus problems and here is a link to his talk.
Further info
https://www.marfantrust.org/articles/pectus-update
https://www.england.nhs.uk/publication/interim-clinical-commissioning-urgent-policy-statement-pectus-surgery/
