ABSTRACT
I. DEFINITIONS A. Pectus Excavatum Pectus excavatum is the most common congenital chest wall deformity and is characterized by excessive depression and, frequently, rotation of the sternum (Fig. 1). It occurs in an estimated I:300 live births, with many of these children outgrowing their deformity. Also known as funnel chest, this anomaly develops from the overgrowth of costal cartilages that curve dorsally and rotate, displacing the caudal sternal body. Usually, this pattern is found at ribs 4--8 where there is frequently greater posterior rotation to the right. An abnormality in the growth of the anterior diaphragm can accompany the development of this disease. The specific cause of pectus excavatum is unknown (I); however, a family history of disease is reported in 13--41 % of patients (10), suggesting a genetic predisposition. Histological findings characteristic of necrosis and inflammation have been observed, but their significance is unknown. Marfan's disease, scoliosis (15%), congenital heart disease (2%), and functional heart murmurs are seen in association with pectus deformities. Some authors recommend screening all patients with severe forms of pectus excavatum for Marfan's disease. This abnormality is rare among African-Americans. Males are affected four times as often as females.
