Bird chest disorder, also known as pectus excavatum, is a condition characterized by a sunken or caved-in chest. It is caused by an abnormal formation of the ribs and sternum (breastbone).
What causes bird chest disorder?
The exact cause of pectus excavatum is not known, but it is thought to be due to overgrowth of the cartilage that connects the ribs to the sternum. This overgrowth causes the sternum to grow inward, resulting in a concave chest deformity. Pectus excavatum is sometimes an inherited condition and can affect multiple members of the same family.
What are the symptoms of bird chest disorder?
The hallmark symptom of pectus excavatum is a depression or dip in the breastbone and adjacent ribs. Other symptoms may include:
- A caved-in or sunken appearance of the chest
- Raised ribs due to the sternum sinking in
- Shortness of breath, especially during exercise
- Fatigue and decreased stamina
- Chest pain or tightness
- Heart palpitations
- Scoliosis
How is bird chest disorder diagnosed?
Pectus excavatum is diagnosed through a physical exam and medical imaging tests. A doctor will visually inspect the chest for signs of a concave deformity. They may also assess the degree of the deformity by measuring the deepest point of the depression in relation to the ribs and sternum.
Imaging tests used to confirm pectus excavatum include:
- Chest X-ray – Shows abnormal position of sternum and ribs
- CT scan – Provides 3D images of the chest to assess deformity
- Echocardiogram – Used to check for cardiac complications
- Pulmonary function tests – Assess breathing and lung capacity
What is the treatment for bird chest disorder?
Treatment for pectus excavatum aims to correct the chest deformity and relieve any symptoms:
- Bracing – Use of a custom-fitted compression brace worn under clothes to apply pressure and push the sternum outward over time. Most effective in children.
- Surgery – The two main surgical options are the Ravitch procedure which removes cartilage and reconstructs the chest, and the Nuss procedure which inserts a bar under the sternum to push it out.
- Physical therapy – Breathing exercises and strength training can help improve chest mobility and function.
Surgery is often recommended for more severe cases and when bracing is ineffective. The optimal age for surgery is late childhood around 10-12 years old when the chest is still malleable.
What are the possible complications?
Potential complications of untreated pectus excavatum include:
- Worsening of chest deformity
- Compression of the heart and lungs
- Heart and breathing problems
- Pneumonia and respiratory infections
- Arrhythmias and heart failure
- Reduced stamina and exercise intolerance
- Psychological effects like poor self-esteem
That’s why early evaluation and management are recommended, especially in children as the chest bones are still developing.
Who is affected by bird chest disorder?
Key facts about the epidemiology of pectus excavatum include:
- More common in males than females, with male to female ratio estimated between 3:1 to 9:1
- Occurs most frequently during rapid growth phases in childhood and puberty
- Estimated to affect 1 in 400-1000 children worldwide
- Family history identified in 30-40% of cases
- Severity and impact on cardiopulmonary function varies widely
While pectus excavatum can affect adults, it typically presents and is treated in childhood or teen years. Prompt evaluation is recommended if chest deformity is detected.
What is the prognosis for bird chest disorder?
The prognosis for pectus excavatum depends on several factors:
- Severity of the deformity
- Patient’s age at diagnosis
- Presence of cardiac or pulmonary symptoms
- Response to treatment
In mild cases without symptoms, patients can live normal lives with just periodic monitoring of the deformity. Bracing will be effective in about 60% of children treated.
For more severe cases, surgery before skeletal maturity yields excellent outcomes in over 90% of patients. Following surgery, the chest shape and function are much improved.
With treatment, the majority of people with pectus excavatum can expect relief of symptoms, improved appearance, and normal cardiopulmonary function. Regular follow-up care is advised to monitor for recurrence.
How can bird chest disorder be prevented?
There are no definitive ways to prevent pectus excavatum, since the exact cause is still unknown. However, the following measures may help reduce the risk:
- Avoid smoking during pregnancy – Maternal smoking may increase risk.
- Proper nutrition and prenatal care – Ensure optimal growth and bone development.
- Early intervention with bracing – When detected in young children, bracing for 1-2 years may prevent progression.
- Physical therapy exercises – Strengthen respiratory muscles and improve posture.
- Monitor family history – Screen children with family members affected.
While not always preventable, the condition is highly treatable, especially when detected early. Raising awareness empowers parents to identify symptoms and seek prompt treatment.
Conclusion
Pectus excavatum is a chest wall deformity that causes a sunken or caved-in appearance of the sternum and ribs. Though the exact cause is unknown, it involves overgrowth of the costal cartilage. Early diagnosis and treatment is key, with options including bracing and surgery to correct the deformity, relieve symptoms, and prevent complications. The outcome for most patients after treatment is excellent. Increased awareness and screening enables early intervention and better management of this condition.