Pectus excavatum: Pathophysiology and clinical characteristics

Pectus Excavatum is the most common congenital abnormality of the chest wall. In the majority of the cases the condition is idiopathic. Affected patients tend to have lung volumes that are mildly decreased but within the normal range and they are often associated with mild air-trapping. Many patients show evidence of lower airway obstruction. Exercise intolerance is the most common symptom associated with pectus excavatum, and it is now believed to be due to cardiovascular rather than pulmonary causes. The psychological effect of the deformity often exceeds its actual physical effect. Several surgical techniques are available for the repair of the deformity, although the need for it is still considered controversial by many. The current article provides an in depth review of the pathophysiology and clinical characteristics of pectus excavatum, as well as an overview of the treatment options in order to help the practitioners caring of affected patients in their evaluation. (C) 2009 Elsevier Ltd All rights reserved.