Symptoms are very uncommon. However, a child with an obvious deformity may experience unfortunate psychological effects. Funnel chest is usually associated with postural disorders such as forward displacement of the neck and shoulders, upper thoracic kyphosis, and a protuberant abdomen. Functional heart murmurs and benign cardiac arrhythmias are frequently seen in these individuals, and the electrocardiogram may show right-axis deviation because of the displacement of the heart. In older patients, there may be an appreciable incidence of chronic bronchitis and bronchiectasis.
Depression of the sternum begins typically at the junction of the manubrium and the gladiolus. The xiphoid process may be bifid, twisted, or displaced to one side. Costal cartilages are angulated internally, beginning with the second or third and extending caudally to involve the remainder. In general, the defect tends to be symmetric, but one side may be more depressed than the other so that the sternum deviates from the middle line. An estimate of the cavitary volume may be obtained by filling the depression with water while the patient lies supine. Standard radiographic films reveal that the heart is displaced toward the left side, and lateral films show the displacement of the body of the sternum posteriorly.
