CLINICAL GUIDELINES AND PRIMARY CARE
Nour B. Odeh, MBBS; Ahmed E. Khedr, MBBS; Rawan M. Zeineddine, MD; Abdulrahman Senjab, MBBS; Juan M. Farina, MD; Dawn E. Jaroszewski, MD
Corresponding Author: Dawn E. Jaroszewski, MD, MBA; Department of Cardiovascular and Thoracic Surgery, Mayo Clinic Arizona.
Email: jaroszewski.dawn@mayo.edu
DOI: 10.3122/jabfm.2025.250122R1
Keywords: Access to Care, Cardiology, Care Coordination, Chest Wall, Minimally Invasive Surgical Procedures, Pectus Excavatum, Primary Care Physicians, Primary Health Care, Quality of Life, Referral and Consultation
Dates: Submitted: 03-27-2025; Revised: 07-21-2025; Accepted: 09-22-2025
Status: Volume 39, Issue 1 (Publishes March 2026)
Pectus is the most common congenital chest wall deformity, with Pectus Excavatum being the most prevalent type characterized by a sunken sternum. It has been proven that in severe cases this anomaly can result in cardiopulmonary compromise affecting patients’ daily activity and ability to exercise. Despite the latest research, the deformity may still be viewed by some as a cosmetic issue that does not necessitate treatment. Since primary care physicians are often the first to evaluate these patients, a thorough understanding and comprehensive treatment approach for pectus is needed. Patients with pectus excavatum can present with a wide range of symptoms, although some may be entirely asymptomatic. Depending on the cardiopulmonary impact of the deformity, the severity of symptoms can range from mild exertional dyspnea to syncopal episodes, which may progress with aging. There have been several publications that have documented the improvement in quality of life and cardiopulmonary function that can occur in patients who have undergone repair of their pectus excavatum deformity. This article reviews updated information and recommendations and can serve as a guide to primary care physicians in the diagnosis, evaluation, and referral of pectus excavatum patients.