What is pectus excavatum?

Pectus excavatum is abnormal growth of the ribs and breast bone resulting in a sunken chest. The depression can be in the center of the chest or off to one side. Some children with sunken chest may experience shortness of breath, exercise intolerance, and chest pain. Pectus excavatum, especially when mild, may cause relatively few discreet symptoms, but may affect your child’s body image.

Who gets it?

The exact cause for pectus excavatum is unknown, although there is evidence of a possible genetic link as this often runs in families. Pectus excavatum is more common in boys than in girls. It can be present in very young children, even babies, or it may only become noticeable as the child grows. The dip often becomes more noticeable during growth spurts.

Will my child need surgery?

The need for surgery is best made with a clinical evaluation. Certain tests can be done to help make the diagnosis of pectus excavatum. A CT scan of the chest will help measure the indentation and an echocardiogram (EKG) will help determine any problems with heart function. Sometimes tests to evaluate the possibility of breathing problems (pulmonary function tests) may be needed. There is no perfect test for deciding who can benefit from surgery. Therefore, the decision regarding surgery is usually made by the surgeon together with the child and the child’s family.

Your child’s evaluation

If you or your child’s doctor feels your child may have pectus excavatum, we will schedule an appointment at University of Iowa Stead Family Children’s Hospital in Iowa City or one of our clinics in the Quad Cities or Waterloo. During this appointment, you and your child will meet with one of our surgeons and pediatric surgery team members, and you will be counseled on treatment options, the possibility of surgery, perioperative care, and follow-up treatment.


These videos provide an introduction to music therapy services for the treatment of post-operative pain and anxiety at University of Iowa Stead Family Children’s Hospital.

  • Music Therapy and Surgery: Patient Introduction
    This video provides information about how music therapy might help you feel more comfortable after your surgery at University of Iowa Stead Family Children’s Hospital. Information is provided by staff members as well as former patients and a relaxation exercise concludes the video.
  • Music Therapy and Your Child’s Surgery: An Introduction for Parents
    This video explains how music therapy and relaxation can be used as part of the pain management plan after surgery. Information is provided by staff members as well as former patients. A relaxation exercise concludes the video.

Medical Services