Pectus excavatum (funnel chest)

This page has information for parents on pectus excavatum, commonly known as funnel chest. Here we explain what funnel chest is and how it may affect your child, and how it can be treated.


What is pectus excavatum (funnel chest) and how will it affect my child?

Pectus excavatum (funnel chest) is when your child’s breastbone is pressed inwards and they have a dip between their ribs. 

The deformity may be symmetrical (the same on both sides) or may be more prominent on one side of the chest.

Funnel chest

Some children with funnel chest will live a normal life. For others, it may affect their heart or lung function. Because it affects the shape of their body, some children with funnel chest may feel shy or self-conscious.

How common is it?

About 1 in 300 - 400 children will have funnel chest. It’s more common in boys. 


What causes funnel chest?

We don’t know for sure what causes funnel chest. Sometimes it happens following open heart surgery.

It can run in families and may be an inherited condition, but more research is needed.

About 1 in 10 people with funnel chest also have scoliosis (curvature of the spine).

More rarely, funnel chest may develop as part of a rare genetic disorder. People with Marfan syndrome or Noonan syndrome may have funnel chest as a symptom.


What are the symptoms?

Some children with funnel chest may not experience any symptoms, except the shape of their chest. Others may experience symptoms including:

  • chest pain
  • breathlessness after exercise
  • fatigue
  • fainting or dizziness
  • fast heart rate (tachycardia).

Symptoms may only start when the child is older, and they may get worse with age.


How is it diagnosed?

Funnel chest may be present at birth, or may develop during a rapid growth spurt, in children and adolescents aged 10 and older. The doctor will diagnose it by looking at your child’s chest.

Your child may need an X-ray or CT scan to see whether their lungs are being squashed or compressed. They may also need breathing tests to see how well their lungs are working. 

Cardiopulmonary exercise testing (CPET) and heart scans can tell doctors more about how well your child’s heart is working.


What is the treatment?

Mild cases of funnel chest may not need treatment.

Surgery

If your child’s funnel chest is more severe, the function of the heart and lungs may be affected. They may need surgery.  Surgery may also be advised if they are unhappy with the way their body looks.

The surgery for funnel chest is called the Nuss procedure. It involves placing one or more stainless steel bars (pectus bars) into the chest, to correct the position of the breastbone.

For the first 6 months after surgery, your child will need to avoid contact sports. The bars are left in place for 2-3 years before being removed.

Surgery is usually carried out when your child is in their teens.

Vacuum Bell therapy

In younger children and those not keen on surgery, a Vacuum Bell device may be used to correct the shape of the chest. This is a rubber device in the shape of a bell, which is connected to a pump. The bell is placed on the chest, and the pump is used to suck air out. This creates a forceful pull that lifts the sunken area of the breastbone. It’s used for up to 2 hours a day.

The Vacuum Bell can’t be used for all types of funnel chest, but there are a number of different shapes and sizes available. When used according to instructions for 1-2 years, the Vacuum Bell may be effective for many patients. Your child will be tested to see if it’s likely to be effective before starting treatment.

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Last medically reviewed: September 2019. Due for review: September 2022

This information uses the best available medical evidence and was produced with the support of people living with lung conditions. Find out how we produce our information. If you’d like to see our references get in touch.