Pectus excavatum: a self-check list to prepare for your appointment

By Javier Santana, founder of Pectus Academy · Updated October 2026

Short answer: this list gives no result and does not tell you whether your pectus is mild or severe; only a doctor with the test results can do that. It helps you organize what you see, what you feel and what you want to ask, and take it in writing to your appointment. We do not store any answers: print it or copy it.

1. What do you see?

• When did you first notice it? Has it changed in the past year?
• Is it centered or does it sit to one side?
• Is it localized and deep, or wide and shallow?
• Do your lower ribs stick out?
• Are your shoulders rounded or your back hunched?

Take two photos, front and side, with the same light and the same posture, and repeat them every few months. They show whether it is changing.

2. What do you feel?

Check whatever applies:

• Shortness of breath or extreme tiredness with exercise.
• Less endurance than before.
• Chest pain.
• Palpitations.
• Wheezing during exercise.
• Dizziness or fainting.
• Frequent respiratory infections.

If you checked any, make an appointment with your doctor. And if you have severe chest pain, a fainting episode or shortness of breath at rest, do not wait for the appointment: call your local emergency number (911 in the US) or go to the emergency room.

3. How does it affect you?

• Do you avoid the pool, the beach, locker rooms or any sport?
• Do you choose clothes so it does not show?
• How much do you think about it on a normal day?

Tell your doctor this too. Distress about chest appearance is listed among the symptoms of pectus and counts when deciding what to do.

4. What is your history?

• Family members with pectus.
• Scoliosis or other spine problems.
• Marfan syndrome, Ehlers-Danlos syndrome or another connective tissue condition.
• Heart, clotting or blood vessel problems, or musculoskeletal disorders. They matter if you are considering a vacuum bell, because they are contraindications.

5. What should you ask at the appointment?

• Do I need any tests?
• What is my Haller index or my correction index?
• Does it affect my heart or lungs?
• Am I a candidate for a vacuum bell? Do I have any contraindications?
• Do you recommend physical therapy?
• How often should it be checked?
• If surgery is on the table: which technique, how long with the bar, what recovery and what risks at my age?

Which test answers what?

Why is there no score?

Because a number from a questionnaire would look like a diagnosis, and it would not be one. A pectus can look deep and cause no symptoms, or look slight and weigh on you a lot. Severity is decided by combining the CT measurement, the symptoms and the heart and lung tests. We explain this in mild vs severe pectus excavatum and on our Haller index page.

What we know and what we don't

What we know

• Which symptoms are associated with pectus and which tests are used to assess it.

What we don't know

• Anything about your case: this list does not assess it and does not replace an appointment.

What next?

Once you have been evaluated, read what can be improved without surgery. If you have no symptoms and want to start with posture, download the free guide to the 4 posture mistakes.

This content is educational and does not replace the advice of a healthcare professional. We do not promise a specific result.

Sources

1. Mayo Clinic. Pectus excavatum: symptoms and causes, updated March 14, 2025. mayoclinic.org
2. Mayo Clinic. Pectus excavatum: diagnosis and treatment, updated March 14, 2025. mayoclinic.org
3. Sharma G, Carter YM. Pectus Excavatum. StatPearls, updated February 15, 2026. ncbi.nlm.nih.gov/books/NBK430918
4. Haecker FM, Sesia S. Vacuum bell therapy. Annals of Cardiothoracic Surgery, 2016. annalscts.com
5. St Peter SD, Juang D, Garey CL, et al. A novel measure for pectus excavatum: the correction index. Journal of Pediatric Surgery, 2011;46(12):2270-2273.