"This condition, called shoemaker's chest, is characterized by a sunken chest."
What is Pectus Excavatum (Shoemaker's Chest)?
This condition, called shoemaker’s chest, is characterized by a sunken chest. This condition is usually related to the rib cage, ribs and cartilage tissue and usually does not show any signs of internal organ disease. Although shoemaker’s chest usually occurs in childhood, it can occur at any age.
What are the Symptoms of Pectus Excavatum?
Symptoms of Pectus Excavatum include a depression in the center of the chest, shortness of breath and chest pain. These symptoms are usually more pronounced after physical activity. There may also be rapid fatigue after exercise, coughing and pain in the sternum.
How is Pectus Excavatum (Shoemaker's Chest) Diagnosed?
The diagnosis of shoemaker’s chest can be easily made during a physical examination. However, further medical imaging techniques are used to determine the severity of the disease and whether vital organ status is involved. These may include tests such as computed tomography and magnetic resonance imaging.
What is the Etiology?
The cause of Pectus Excavatum is not known exactly, but genetic factors play a role. It tends to be more common in people with a family history. It has also been associated with some connective tissue disorders.
What are the Complications?
In some patients, shoemaker’s chest can lead to respiratory and heart problems. The pressure on the heart and lungs can be especially pronounced during physical activity.
Shortness of Breath and Difficulty Breathing
Pectus Excavatum prevents the lungs from fully expanding. This can affect the respiratory capacity and cause difficulty in breathing.
Heart Problems
The inward depression of the chest can prevent the heart from functioning normally. This can be particularly pronounced during physical activity.
Chest Deformity
This may lead to aesthetic concerns. A prominent dimple in the center of the chest may negatively affect the self-esteem of the individual.
What are the Effects on Internal Organs?
The shoemaker’s chest does not cause direct damage to the internal organs. However, the abnormal shape of the rib cage can cause pressure on the heart and lungs.
What are the Treatment Methods?
Non-Surgical Methods
The Vacuum Bell is a non-invasive method. It aims to correct the dimple by exerting an external influence on the rib cage. Lifestyle changes and physiotherapy also support this process. It can be tried in almost every age group. In childhood, the chances of treatment with this method are higher, but there are cases of failure. It is usually applied in the morning and evening, with corrective procedures performed by the patient with the vacuumbell device. After the measurements are taken by the physician, success is achieved in a period of about one year. Side effects are negligible. The success rate depends on the patient’s patience. The device is not covered by SGK reimbursement.
Surgical Methods
Nuss surgery is one of the most commonly used procedures. The shape of the rib cage is corrected by placing a steel rod under the sternum. Correction is achieved with a steel rod placed under the sternum. Correction occurs immediately, not slowly as in vacuumbell treatment. The implanted prosthesis is removed after 2-3 years depending on the situation. The Nuss method is used in the advanced stage of unsuccessful treatment with Vacuumbell.
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