64% were out of breath.
Under 3% hit a lung limit.

3 studiesFrom my Instagram carousel

  1. 64% of pectus patients in one study got out of breath on exertion. Excerpt from Hardie et al., Pediatric Pulmonology 2021, PMID 34143574: "Of 259 patients studied, dyspnea on exertion and chest pain was reported in 64% and 41%, respectively."
  2. The study: "Ventilatory limitations are not associated with dyspnea on exertion or reduced aerobic fitness in pectus excavatum", Pediatric Pulmonology 2021, Hardie, Powell, Jenkins, Foster, Tretter, Fleck, Garcia, Brown. 259 patients, exercise test, lung function tests, chest MRI, one pectus centre. "A pulmonary limitation during exercise was identified in less than 3%."
  3. What patients reported: the symptoms are real. Out of breath on exertion, 64%. Chest pain, 41%. If this is you, you're not imagining it. Most people in this study felt it too.
  4. What the tests showed. Peak oxygen uptake reduced, 30%. Limits on resting lung tests, 26%. Lung limit during exercise, under 3%.
  5. What the authors concluded: chest depth didn't predict the lung tests. Resting lung tests matched poorly with how deep the chest was, with symptoms, and with fitness. Lung volumes during exercise were only minimally linked to how deep the chest was.
  6. A second study, 345 patients: girls had deeper chests, and better heart and lung function. Better exercise tolerance than the boys too. Depth isn't the whole story. Casar Berazaluce et al., Pediatric Surgery International 2020.
  7. What these studies can't tell you. One: patients came to pectus clinics for checks, so they may not look like everyone with pectus. Two: a small study of 12 boys found lower fitness as a group, with wide overlap (Rowland et al., 2005). Three: numbers come from the published abstracts.
  8. My take: out of breath is real. It's rarely a lung limit. Fitness is the part you can train. That's why it's in every plan I write. New, worsening, or with chest pain? That's a doctor visit first, not a carousel.

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64% of the pectus patients in this study got out of breath when they exercised.

So it must be the lungs? In the same 259 patients, a lung limit during exercise showed up in less than 3%. Resting lung tests didn't line up with how deep the chest was, with symptoms, or with fitness.

A second study of 345 patients found the girls had deeper chests, yet better heart and lung function and exercise tolerance than the boys.

The numbers

64%
of 259 patients got out of breath on exertion.Hardie 2021
41%
had chest pain.Hardie 2021
30%
had a reduced peak oxygen uptake.Hardie 2021
26%
showed limits on resting lung tests.Hardie 2021
Under 3%
hit a lung limit during exercise.Hardie 2021
345
patients in a second study. The girls had deeper chests, yet better heart and lung function and exercise tolerance than the boys.Casar Berazaluce 2020

My take

The breathlessness is real, and it's rarely a lung limit. Fitness is the part you can train, which is why it's in every plan I write.

If it's new, getting worse, or comes with chest pain, see a doctor first.

What these studies can't tell you

  • These patients came to pectus clinics for checks, so they may not look like everyone with pectus.
  • A small study of 12 boys found lower fitness as a group, with wide overlap.
  • Numbers from the published abstracts.

Sources

  1. Hardie W et al. Pediatr Pulmonol. 2021 Sep;56(9):2911-2917. PubMed 34143574 doi:10.1002/ppul.25540
  2. Casar Berazaluce AM et al. Pediatr Surg Int. 2020 Nov;36(11):1281-1286. PubMed 32940825 doi:10.1007/s00383-020-04738-5
  3. Rowland T et al. Arch Pediatr Adolesc Med. 2005 Nov;159(11):1069-73. PubMed 16275799

Not medical advice.

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