Common Chest Wall Conditions and How We Can Treat Them

Common Chest Wall Conditions and How We Can Treat Them

Most of us take breathing in and out for granted until it becomes labored and painful — then, fear sets in.

Don’t panic. Our board-certified experts at Rockland Thoracic & Vascular Associates specialize in diagnosing and treating complex heart and lung issues, and we can get to the bottom of your chest pain quickly, so you can get back to breathing easily.

Although chest pain immediately conjures thoughts of serious conditions like heart disease and cancer, the problem often involves the structure of the chest wall.

Common chest wall conditions

Several conditions can affect the chest wall, but not all are common. Here’s a look at the potential problems.

Pectus excavatum

The most common chest wall condition is pectus excavatum or sunken chest. It’s a genetic disorder that affects the development of the sternum and ribs, causing the chest to appear caved in.

Pectus excavatum may be noticeable at birth or appear during adolescent growth spurts. This structural deformity places pressure on the heart and lungs, causing chest pain, fatigue, rapid heartbeat, coughing, and difficulty tolerating exercise.

Mild cases of pectus excavatum present a cosmetic problem but generally aren’t considered medically relevant. Surgery is the most effective treatment if severe structural deformity interferes with heart and lung function. 

We perform one of two highly successful procedures. The Nuss procedure creates a tunnel under the breastbone, so we can insert a customized bar that guides the chest wall as it develops. This is a minimally invasive technique that requires only one small incision.

When necessary, we perform a traditional open surgery called Ravitch repair to remove abnormal cartilage, reposition your breastbone and ribs, and reinforce the chest wall with titanium bars. 

Pectus carinatum

The opposite of pectus excavatum, pectus carinatum is when the ribs and breastbone grow with an outward curvature that makes the chest appear to be jutting out. The resulting shape earned it the nickname “pigeon chest.”

Like pectus excavatum, pectus carinatum is congenital and tends to run in families. Symptoms aren’t always present, but when they are, they are the same as those experienced with pectus excavatum: shortness of breath, fatigue, fast heart rate, and chest pain. 

If a child with pectus carinatum experiences breathing problems, we may recommend a chest brace to help guide the bone development externally. They need to wear it at least eight hours a day but can remove it to shower and play sports. 

We may recommend the Ravitch procedure to repair severe deformities in extreme cases.

Lesser-known chest wall conditions

Any disease that affects your chest wall — your ribs, breastbone, respiratory muscles, and nerves — can also affect your heart and lung function by placing undue force on the organs or limiting the space necessary for full lung volume. 

Here are some conditions that may cause chest wall problems.

Congenital conditions

Poland syndrome: missing all or part of major chest muscles at birth

Asphyxiating thoracic dystrophy: short ribs and narrow chest

Fibrodysplasia ossificans: a rare disease where connective tissue turns to bone

Spinal conditions

Kyphosis: weakened, aging spinal bones cause hunching and pressure on the chest wall

Scoliosis: side-to-side spinal curvature that can crowd the chest capacity

Traumatic injuries

Flail chest: thoracic trauma caused by three or more ribs fractured in more than two places

Disease

Chest wall tumors: benign or cancerous growths in the chest wall

Lifestyle

Obesity: can lead to asthma, COPD, and obstructive sleep apnea, and reduces chest wall capacity

Whatever’s causing your chest wall issues, we can help. We have multiple offices in Washington Heights (Manhattan), Pomona, Goshen, and Fishkill, New York, and Englewood, New Jersey, making it convenient to get the help you need. Contact us by phone or online.

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