Pectus Excavatum Symptoms

Evidence Based This post has medical citations

Pectus Excavatum Symptoms

Pectus excavatum symptoms can be classified into two categories.

  • Psysical
  • Psychological

The physical signs are much more apparent. All you need to do is take your shirt off and look at the bone construction of your chest. That’s where you can see most of the physical indicators.

These exist in every single patient. These will get more obvious during the teenage years. That’s the time when the deformity starts to get worse. You’ll feel strange and insecure about the looks of your chest, which will trigger an emotional response.

Physical Indicators

The main physical indication of pectus excavatum is a cavity of the breastbone in an inward direction. This gives the chest a sunken appearance. Generally, the indentation is shaped like a cup. It is dominant in the bottom end of the breastbone.

Additionally, in severe cases, the upper costal cartilages are also likely to sink in. In some patients, the hole in the chest continues to get worse during adulthood.

In my opinion, this is worsened by a lack of physical activity, poor posture, weak musculature, and an unhealthy lifestyle. Don’t let this happen to you, because it can harm your health.

Science has proven that the sternum can compress the heart and lungs in severe cases of pectus excavatum. This can lead to intolerable pain in the chest and back, which will translate to depression and insomnia. You don’t want the indented chest deformity to cause you problems later in your life.

As you can see, the physical symptoms translate to psychological problems. In almost all cases of pectus excavatum, the lower ribs may poke out.

This is known as “flared ribs“. Generally, this becomes more visible if your core muscles are weak, and you suffer from forward head posture and anterior pelvic tilt. The pectus excavatum symmetry can differ. It is categorized as symmetrical and asymmetrical.

In most cases, the left side of the rib cage is more flared. Below, you can see the six most common physical symptoms of pectus excavatum.


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

Reduced workout capacity – A large body of scientific literature proves that patients suffering from pectus excavatum have a reduced exercise capacity. The deformity causes the air in the lungs to be trapped, leading to exertional dyspnea (shortness of breath while 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 while wearing a close-fitting military vest.

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.

Some of the most common chronic lung infections are the common cold, bronchopneumonia, chronic sinusitis, chronic bronchitis, rhinitis, streptococcal sore throat, and nausea.

Usually, these infections occur during the fall and winter seasons. Treatment is based on the symptoms the sufferer is experiencing.

Wheezing or Coughing

Some patients encounter a seal-like barking cough. This usually occurs only in severe cases. Surgical repair is the best way to fix this. Wheezing, high-pitched, rough whistling noise you make when you breathe, is typically induced by exercise.

It also 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 typically of musculoskeletal origin. This type of pain is closely related to sleeplessness, stress, and depression.

The pain is mostly created by compression of the sternum to the heart and lungs. Just thinking about it can cause significant discomfort.

Physical Activity Limitations

Engaging in physical activities can be very demotivating because some may require a lot of endurance, which is significantly affected by the condition. Such activities are running, swimming, and climbing.

Also, competing in contact sports like soccer, basketball and football can be severely limited. Not only will you have stamina problems, but you are also likely to have a weaker physical frame than the competitors, especially 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

A Haller index within the ranges of 2 and 3.2 is considered a mild deformity. If your pectus excavatum is mild, the indentation of the chest is obvious, but it doesn’t affect the functioning of the heart and lungs as in patients with a severe cavity.

Usually, the patients with mild PE don’t suffer a lot psychologically, because they aren’t very stressed about their body appearance. However, this wasn’t the case with me. I was obsessed with my chest wall appearance.

Of course, this will vary from one person to another, as we are all differently set up mentally. In moderate cases, the heart can be dislocated or rotated, and the lung capacity will be reduced. If you’re aware of this, it can make you pretty uncomfortable.

Generally, patients with Haller Index < 2.5 don’t need any treatment because the deformity doesn’t distress the heart and lungs.  In the United States, if patients with PE have a Haller Index  lower than 3.25, they aren’t good candidates for a minimally invasive Nuss procedure and the surgery costs aren’t covered with insurance.

The non-surgical way of improving PE is ideal for patients with a moderate indentation.


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

A Haller Index equal to 3.5 or greater is categorized as severe. The most visible sign of a severe case is a chest that looks like its midpoint has been scooped out.

This results in a considerable indentation. You can easily determine whether a deformity is severe or mild, even without a Haller Index measurement.

However, some patients want to know what else contributes to the severity of pectus excavatum. Regularly, these patients have restricted cardiac and lung functioning.

If the dent is deep enough, the heart is squeezed and pushed over to the side. In some cases, this creates dextroscoliosis (scoliosis on the right side).

This reduces the heart’s blood-pumping ability. I will talk about the cardiac symptoms in more detail below. In this case, the deformity isn’t just a cosmetic issue.


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

Almost every teenage patient with pectus excavatum experiences psychological symptoms. They can be easily noticed. In 1999, Einsiedel and Clausner discovered that the psychological symptoms of the deformity are prominent after 11 years of age.

The most common symptoms are anxiety, self-observation, lack of motivation for activities and social interaction, shyness, passive-aggressiveness, negativity and frustration.

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 health problems before surgical correction.

After they examined the patients 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 symptoms were corrected after successful chest remodeling. If you feel the presence of any of these psychological symptoms, I recommend you schedule an appointment with a psychiatrist.

That can significantly improve the quality of your life. Don’t underestimate the psychological harm the deformity can cause. It has ruined the self-confidence of many young patients, including mine.


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.

Article by:

Mihail Veleski

My name is Mihail Veleski. I used to suffer from the pectus excavatum deformity during my teenage years.

2 thoughts on “Pectus Excavatum Symptoms”

  1. Yo I’m 32 years old and been on a super long def healing journey, I just went to chiropractor and it’s been bringing all sorts of issues today. I started getting super paranoid about my pectus excavatum and my ribs are flared. I’m really interested in your techniques and possibly coaching this is is so inspiring. Please reach out to me.


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