Is pectus excavatum hereditary?

Written by Zhang Zhi Gong
Cardiothoracic Surgery
Updated on February 02, 2025
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In current medical technology, although no genes exclusively associated with pectus excavatum have been identified, there is evidence suggesting genetic predisposition when pectus excavatum coincides with other conditions. For instance, the incidence of pectus excavatum is significantly higher in patients with congenital connective tissue disorders, such as Marfan Syndrome, and is linked to certain genes within this syndrome. Additionally, patients with congenital diaphragmatic hernia also show an increased incidence of pectus excavatum. Moreover, the condition is more prevalent in patients, or children, who have subglottic airway stenosis or congenital bronchopulmonary dysplasia. Thus, these evidences confirm that pectus excavatum, as a disease in itself, is directly or indirectly related to congenital genetic factors, indicating a certain hereditary nature.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Does pectus excavatum hurt?

The sternum of pectus excavatum caves inward and backward, directly compressing the patient's heart or lungs, causing a certain degree of chest pain. This chest pain is not caused by pectus excavatum itself, but by the compression of the heart or lungs due to pectus excavatum. Imagine a normal ribcage as an oval shape; its cross-section is also oval and is a ratio of the patient's left-right diameter, transverse diameter, and anterior-posterior diameter. In normal individuals, this ratio is less than 2.5. In pectus excavatum, since the anterior-posterior diameter is significantly reduced and the sternum is markedly pressed towards the spine, the patient's heart is entirely compressed and deformed. Therefore, the patient's coronary arteries or valves may be squeezed and deformed, resulting in about 60% of pectus excavatum patients experiencing chest pain.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Pectus excavatum should go to which department?

Regarding the registration of patients or children with pectus excavatum, if it is for children and the consultation is only about the hereditary aspect of pectus excavatum or its etiology, consider registering at the pediatrics or child health department. It is also feasible to consult the genetics department. If the consultation is about treatment options for pectus excavatum, including methods of treatment, consider registering at the thoracic surgery department. Thoracic surgery can provide advice and methods for the treatment of pectus excavatum, including both surgical and non-surgical options. Of course, not all hospitals have a thoracic surgery department; generally, municipal third-level, first-class hospitals are equipped with thoracic surgery departments. If there is no thoracic surgery available, consider registering under the general surgery department.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Does pectus excavatum require surgery?

The decision on whether surgery is needed for pectus excavatum depends on the patient's age, the severity of the deformity, and the elasticity of the chest wall. If the patient is very young, under one year old, and the pectus excavatum is not very severe, we recommend a watchful waiting approach. In patients with pectus excavatum under one year old, it is possible that the condition is pseudopectus excavatum, which may improve as they grow and develop within the first year. However, not everyone improves, with about one third of the cases showing improvement within the first year. If the child is older than one year, the likelihood of improvement is basically none, and at this time, conservative treatment using a pectus excavatum suction cup can be considered. If adhered to effectively, the suction cup can have a certain effect for some patients with pectus excavatum. But if the patient is over three to five years old and the chest wall has matured, surgery should be considered. Therefore, for the vast majority of patients with pectus excavatum, surgery is a relatively definitive and immediately effective method.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Can people with pectus excavatum join the military?

Theoretically, the current conscription system does not have strict restrictions on mild cases of pectus excavatum. However, obvious moderate or severe pectus excavatum, or sternums that are inwardly and backwardly concave, can significantly impact the function of both the heart and lungs by compressing them. This inward concavity can restrict the heart’s ability to fully expand, potentially causing complete deformation of the heart, or even prevent the heart’s valves from closing fully, leading to valve regurgitation. Such compromised cardiac and pulmonary functions are likely unable to withstand the physical demands experienced during military service. Therefore, for moderate and severe cases of pectus excavatum, we do not recommend enlisting in the military, although the current policy does not have clear restrictions on mild cases of pectus excavatum.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
1min home-news-image

Is pectus excavatum hereditary?

In current medical technology, although no genes exclusively associated with pectus excavatum have been identified, there is evidence suggesting genetic predisposition when pectus excavatum coincides with other conditions. For instance, the incidence of pectus excavatum is significantly higher in patients with congenital connective tissue disorders, such as Marfan Syndrome, and is linked to certain genes within this syndrome. Additionally, patients with congenital diaphragmatic hernia also show an increased incidence of pectus excavatum. Moreover, the condition is more prevalent in patients, or children, who have subglottic airway stenosis or congenital bronchopulmonary dysplasia. Thus, these evidences confirm that pectus excavatum, as a disease in itself, is directly or indirectly related to congenital genetic factors, indicating a certain hereditary nature.