Pectus Excavatum Symptoms

Symptoms of pectus excavatum can be divided into two categories.

  • Physical 
  • Psychological 

The physical symptoms are much more obvious.

All you need to do is take your shirt off and look at the bone structure of your chest.

That’s the area where most of the symptoms are. 

The psychological indicators of pectus excavatum are present in almost every single patient.

These will become more obvious during your teenage years. 

That’s usually the time when the pectus excavatum deformity will become more obvious.

You’ll feel weird about it, which will trigger an emotional response. 

I will talk about these two types of pectoralis excavatum signs separately, in the text below.

Physical Indicators

The main physical symptom of pectus excavatum is a cavity of the sternum in the chest.

Generally, the cavity is shaped like a cup. 

The dent is dominant at the bottom end of the breastbone. 

Additionally, a bigger dent in the upper coastal cartilages is probable.

In some patients, the hole in the chest gets worse in the teenage years and continues during adulthood.

This is due to a lack of physical activity, poor posture, and an unhealthy lifestyle.

You shouldn’t allow this to happen, because it can harm your health. 

Science has proven that in severe cases of pectus excavatum, the sternum may compress the heart and lungs. 

This can lead to intolerable pain in the chest and back. That will translate to depression and insomnia. 

You don’t want the indented chest deformity to cause you problems in later life. 

In almost all cases of pectus excavatum, the lower ribs may flare out. This is known as “protruding ribs”. 

Usually, this occurs if you have a weak core musculature, forward head posture, and anterior pelvic tilt. 

These are all treatable, which means you can fix the flared ribs deformity caused by pectus excavatum. 

The symmetry in the concave chest deformity can vary. It can be even or uneven.

Usually, the left side of the rib area is protruding.

This isn’t very appealing. It is in your best favor to correct this. 

In the text below, I’ll list the six most common physical signs of the indented chest deformity.


A sunken chest appearance is the most common physical symptom of the deformity.

Top 5 Most Common Physical Signs of Funnel Chest

Reduced Workout Capacity

Large body of scientific literature proves that patients suffering from pectus excavatum have a cardiac restraint to exercise.

The deformity causes the air in the lungs to be trapped, leading to exertional dyspnea (shortness of breath during working out).

Patients are not able to get enough air, which will lead to stamina and endurance problems.

A study revealed that a pectus excavatum patient couldn’t even tolerate walking with a close-fitting military vest on. 

That raises the sufferer’s anterior chest wall compression, even more, leading to breathing issues.

Frequent Lung Infections

A 30-year-long study done at the UCLA Medical Center revealed that 32% of all 375 patients with pectus excavatum had recurrent respirational infections.

Few examples of chronic lung infections include common cold, bronchopneumonia, chronic sinusitis, chronic bronchitis, rhinitis, streptococcal sore throat, and nausea.

Usually, the respirational infections caused by the indented chest deformity occur during fall and winter seasons.

Treatment is based on the symptoms the sufferer is experiencing.

Wheezing or Coughing

Patients with pectus excavatum experience a seal-like barking coughing.

This happens when the deformity is in the severe stage. 

Surgical repair is the best way to fix this.

The wheezing is typically inducted by exercising. 

That’s a high-pitched, rough whistling noise you make when you breathe.

It usually occurs when the fever season starts.

Chest & Back Pain

Depending on the severity, people with pectus excavatum may experience chest and back pain.

This ache is typical of musculoskeletal origin.

This type of pain is closely related to insomnia, anxiety, and depression. The pain is mostly caused by compression of the sternum to the heart and lungs. 

Just the thought of this alone can cause major discomfort.

Physical Activity Limitations

Participating in certain physical activities can be very unmotivating.

For instance, these are activities that require a lot of lung capacity and endurance. 

Activities such as joggingswimming, and climbing can be very limited. 

Also, participating in contact sports like soccer, basketball, and football can be severely restricted.

On top of conditioning problems, you will usually have a weaker frame than competitors, if you aren’t a fan of the weight room.


Pectus excavatum can cause physical problems that will affect your quality of life.

Mild Pectus Excavatum Symptoms

The mild pectus excavatum symptoms can hardly be noticed. All you can notice is a slight dent in the sternum.

Usually, patients that have a mild sunken chest deformity aren’t stressed out about their body appearance.

In these cases, the cardiorespiratory function is regular.

However, the heart can be dislocated or rotated. That’s a direct cause to make kids that have a mild case of the deformity to feel uncomfortable about their body structure. 

People with mild pectus excavatum don’t need any treatment if the deformity doesn’t distress the lung and heart work.

They aren’t good candidates for a minimally invasive Nuss procedure. 

Their anterior chest walls can be easily fixed through physical therapy, bracing, and using a vacuum bell. 

Pectoralis excavatum can be categorized depending on the severity. It can be mild, moderate, and severe.

The severity is estimated by doing a CT scan on the chest, pulmonary function testing, and cardiology assessment. 

The purpose of the CT scan is to determine the Haller Index of the deformity. 

Normal chest bone structure has a HI equal to 2 or less. Haller Index between 2 and 3.2 is considered mild.


The mild case of the inverted chest deformity is barely visible, and because of that the patients don't suffer psychologically.

severe pectus excavatum symptoms

The most obvious sign of a severe pectus excavatum is a chest that looks like its midpoint has been scooped out. This results in a huge indentation.

You can easily conclude whether the deformity is severe or mild. Unless you undergo surgery, there is no need to measure the Haller Index of your chest. 

However, some patients want to know other signs of a severe case of pectoralis excavatum.

Usually, people who suffer from a severe case have restricted cardiac and lung functioning. The sternum compresses these sensitive organs.

If the dent is deep enough, the heart is squeezed and pushed over to the side. 

This decreases its blood pumping competence.

I will talk about the cardiac symptoms in more detail below.
In this case, the deformity isn’t just a cosmetic issue.

Sometimes these symptoms can be critical enough to justify a correctional surgical procedure. 

If your chest is indented severely, but you don’t feel any chest pain, I first recommend you try a non-surgical correction approach.

Always consult with your doctor before starting any workout program.

Stop immediately if you feel a sharp pain in the chest and shortness of breath during the training sessions. 

The non-surgical rehabilitation of pectus excavatum involves the physical treatment, wearing corrective braces and a vacuum bell therapy.

If this doesn’t improve your funnel chest deformity after a few months, you should consider undergoing a minimally invasive Nuss procedure.


A severely indented sternum can cause heart and breathing problems. Because the dent is obvious, the sufferers are prone to psychological struggle. 

Pectus Excavatum Cardiac Symptoms

The most common pectus excavatum cardiac symptoms are progressive heart palpitations, rapid heartbeat, cardiac arrhythmia (irregular heartbeat), and a heart expansion restriction.

These symptoms get more evident as the patient reaches puberty or early adulthood.

That’s the exact period when the pectus excavatum deformity becomes more bulging. 

The cavity in the anterior chest wall displaces the positioning of the heart, causing various problems.

The heart will get dislocated because the sternum presses against it. With the displacement, the cardiac compression is evaded.

Usually, this is the case with younger patients that have very stretchy chests. As these patients get older, the chest wall flexibility declines.

Their chests become stiffer.

When this happens, the heart’s turning to the side is less likely to happen.

This is bad because the heart compression increases. 

Therefore, pectus excavatum cardiac symptoms are usually felt in adulthood.

Most young patients don’t notice any heart indicators because their chest walls are still flexible. 

If you feel these irritating symptoms, feel free to consult with a cardiologist or a surgeon.


The heart symptoms of the deformity are usually felt in the adult years. 

Psychological Signs of Concave Chest

The psychological symptoms of pectus excavatum can be easily noticed, especially in teenagers.

If you notice that you have an indentation in your chest and a few of these mental symptoms, then there is a high chance that you suffer from pectus excavatum.

Einsiedel and Clausner concluded that the mental signs of deformity are prominent after 11 years of age. 

The most common symptoms are Anxiety, self-observation, nonexistent motivation for activities and social interaction, shyness, dormant aggressiveness, negativity, frustration.

Patients with hollow chests often have appearance worries and social anxiety. That will translate to psychological distress.

A recent study approved by the General Hospital of Beijing Military Region in Beijing, China, concluded that 153 out of 266 patients with pectus excavatum had mental issues before surgical correction. 

After they observed the patient's one-year post-operation, doctors saw tremendous improvement in their mental health. 

All psychological disorders connected with their bodily appearance decreased. 

The study concluded that all the above-mentioned mental indications of pectoralis excavatum were corrected after successful chest remodeling.

If you feel the presence of any of these psychological symptoms, I recommend you seek help from a therapist.

That can greatly improve the quality of your life. 

Don’t underestimate the psychological harm the deformity can cause.

It ruined the self-confidence of many young patients for the rest of their life. 

You must have strong willpower to overcome this deformity both mentally and physically.

As you can see, the concave chest deformity affects all areas of life. You must be aware of the damage it can cause.


After 11 years of age, the psychological symptoms of pectus excavatum take full effect. 


In this article, I discussed the most occurring indications of pectus excavatum.

Thanks to these symptoms, you can easily consider whether you have the deformity or not.

Usually, patients have a dent in the middle of the chest and flared ribs.

That’s the most common bodily symptom.

The pectus excavatum symptoms often vary in severity. Their effect on the patient’s daily activities differs. 

Pectus excavatum can get worse with age, especially if your posture is poor and your musculature is weak.

If you have the most common signs of deformity, it is in your favor to start a process of correction.

I am a huge fan of the non-surgical repair approach. 

The psychological indicators of pectoralis excavatum can harm the quality of your life.

You’ll have trouble socializing with your peers and attracting members of the opposite sex. 

Always consult with a psychotherapist if the indented chest deformity is damaging your mental health.

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