12 Symptoms of Pectus Excavatum [2023]: Physical + Mental

Written by Mihail Veleski

Last updated on: April 25, 2023

Pectus excavatum symptoms can be classified into two categories:

  • Physical
  • Psychological


The physical signs are much more apparent. The main physical indication of pectus excavatum is a cavity of the breastbone in an inward direction. This gives the chest a sunken appearance. All you need to do is take your shirt off and look at the shape of your chest.

Generally, the indentation is shaped like a cup. It is dominant in the bottom end of the breastbone. In severe cases, the upper costal cartilages are also likely to sink in. In some patients, the hole in the chest worsens during adulthood.

A lack of physical activity, poor posture, weak musculature, and an unhealthy lifestyle worsen this. 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 have 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 five most common physical symptoms of pectus excavatum.



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 cannot get enough air, which leads 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, leading to breathing issues.


A 30-year-long study 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:

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


Some patients encounter a seal-like barking cough. This usually occurs only in severe cases. Surgical repair is the best way to fix this. The wheezing, high-pitched, harsh whistling noise you make when you breathe is typically induced by exercise. It also occurs when the fever season starts.


Depending on the severity, people with pectus excavatum may experience chest and back pain. This ache is typical of musculoskeletal origin. This pain is closely related to sleeplessness, stress, and depression.

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


Engaging in physical activities can be very demotivating because some may require a lot of endurance, which is significantly affected by the condition. Such actions 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 will also likely have a weaker physical frame than the competitors.


If your pectus excavatum is mild, the indentation of the chest is noticeable. Still, it shouldn’t affect the functioning of the heart and lungs as in patients with a severe cavity. Usually, these patients don’t suffer a lot psychologically because they aren’t very stressed about their body appearance.

Of course, this will vary from person to person, as we are all different set up mentally. The heart can be dislocated or rotated in moderate cases, and the deformity reduces lung capacity. If you’re aware of this, it can make you pretty uncomfortable.

Usually, patients with a mild pectus excavatum don’t need treatment because the deformity doesn’t distress the heart and lungs. These individuals aren’t good candidates for a minimally invasive Nuss procedure. The surgery costs wouldn’t be covered by insurance.


The most visible sign of an extreme case is a chest that looks like its midpoint has been scooped out. You can quickly 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.

The heart is squeezed and pushed over to the side. This sometimes 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.


The most common pectus excavatum cardiac symptoms are:

  • Progressive heart palpitations
  • Rapid heartbeat
  • Cardiac arrhythmia (irregular heartbeat)
  • A heart expansion restriction
  • PoTS

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

When it is displaced, the cardiac compression is evaded. Usually, this is the case with younger patients with 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 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.


Almost every teenage patient with pectus excavatum experiences psychological symptoms. Doctors can quickly notice them. In 1999, Einsiedel and Clausner discovered that the psychological symptoms of the deformity are prominent after 11 years of age.


  • Anxiety
  • Self-observation
  • Lack of motivation for activities and social interaction
  • Shyness
  • Passive-aggressiveness
  • Negativity
  • 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 surgeons corrected all the above-mentioned mental symptoms 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.


In this article, I discussed the most occurring indications of pectus excavatum. Thanks to these symptoms, you can easily consider whether you have a deformity. 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, starting a correction process is in your favor.

I am a massive 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 a psychotherapist if the indented chest deformity damages your mental health.

7 Sources
  • Zhao L, Feinberg MS, Gaides M, Ben-Dov I. Why is exercise capacity reduced in
    subjects with pectus excavatum? J Pediatr. 2000 Feb;136(2):163–7.
  • Tardie GB, Dorsey DA, Kaeferlein BH. Evaluation of Unexplained Dyspnea in A
    Young Athletic Male with Pectus Excavatum. J Sports Sci Med. 2005 Sep
  • Fonkalsrud EW, Dunn JC, Atkinson JB. Repair of pectus excavatum deformities:
    30 years of experience with 375 patients. Ann Surg. 2000 Mar;231(3):443–8.
  • Kim RY, Baker CJ. Pectus excavatum and chest pain: a case report. Cases J. 2008
    Nov 25;1:351.
  • Pectus excavatum: Not just a cosmetic concern - Mayo Clinic [Internet]. [cited
    2022 Nov 24]. Available from: https://www.mayoclinic.org/medical-professionals/cardiovascular-diseases/news/pectus-excavatum-not-just-a-cosmetic-concern/mac-20430716
  • Einsiedel E, Clausner A. Funnel chest. Psychological and psychosomatic aspects
    in children, youngsters, and young adults. J Cardiovasc Surg (Torino). 1999
  • Luo L, Xu B, Wang X, Tan B, Zhao J. Intervention of the Nuss Procedure on the
    Mental Health of Pectus Excavatum Patients. Ann Thorac Cardiovasc Surg Off J
    Assoc Thorac Cardiovasc Surg Asia. 2017 Aug 20;23(4):175–80.

Article by:

Mihail Veleski

I am Mihail Veleski, the person behind this website. Established in 2015, Pectus Excavatum Fix (Now Mr. Pectus), has helped thousands of people improve their sunken chest deformity, both physically and mentally. I pride myself on ensuring the information and methods I share are tried by me and backed by research. I improved my concave chest and rib flare deformities non-surgically.

3 thoughts on “12 Symptoms of Pectus Excavatum [2023]: Physical + Mental”

  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.

  2. Hey man, your entire website has helped me so much. I just turned 22 and I am starting vacuum bell therapy on my own, I’m not sure what my haller index is but when I measure my pectus from the outside, it is nearly 2cm deep. I am so thankful for all of the stuff you have put out on this site, I have learned so much from you and it makes me feel I am not alone in this. I strongly feel that my pectus is the reason for some difficulty in eating certain foods (others on reddit have said the same) and my palpitations. One question I have is can you explain the mechanism of how the vacuum bell can cause dizziness? And also if bruising occurs, should I stop using the vacuum bell for a day or two?
    Thank you so much Mihail


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