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Pectus excavatum can compromise lung and heart capacity, especially when it is severe, causing the patient to experience reduced exercise tolerance, fatigue, shortness of breath, chest pain, and a fast heartbeat. In some patients, there may be a heart murmur caused by the proximity of the sternum and the pulmonary artery. For ordinary everyday activities, a person with pectus excavatum may have no symptoms, however with rigorous exercise, symptoms often appear. Lung capacity may be curtailed because lungs are confined and cannot properly expand. During exercise, the patient compensates by engaging the diaphragm in breathing in order to enable the lungs to expand more and obtain adequate oxygen and carbon dioxide exchange for the demands of the body. The additional energy utilized for breathing in this manner contributes to fatigue. Patients with severe pectus excavatum, often notice that they are incapable of similar levels of activity as their peers. This can be especially difficult for adolescents and teenagers, who often withdraw from participating in sports or other high stress physical activities.
In addition to its more serious symptoms, pectus excavatum may have negative psychosocial effects in child and teen-age patients, who experience self consciousness and difficult peer interactions stemming from their appearance. Often these children and teenagers avoid activities that expose the chest.
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