I have a close friend with a chest condition called Pectus E...

I have a close friend with a chest condition called Pectus Excavatum or sunken chest.

His doctor says he is all right. However, I began to notice that you can see his heartbeats on his chest wall clearly and if you put your hand on his left chest, you can feel the heartbeats clearly as well. One cannot see or feel the heartbeats on the chest of a normal person. Are these things happening to my friend something to worry about?

No, and yes! How about that for an unhelpful sounding answer?!

As long as he's under medical care and is showing no obvious increasing impairment of lung or cardiac function then it is generally considered a "live withable" problem. However, if he's suffering increasing difficulty breathing or his heart shows abnormal activity by tests, then it's something to start to take more seriously.

From what I've read, intervention may or may not provide enough improvement in the effects of the condition to make it worthwhile unless things become more of a problem.

So, the bottom line ... and remember, these comments are no replacement for visiting a doctor! ... ensure that your friend gets regular checkups to evaluate the condition, and that he reports any difficulty breathing or pains from his chest.

Thanks for your comment, stuart.

Actually, I was told he should be all right and his condition is cosmetic. But I am troubled by the pronounced beatings of his heart as you can see or feel them. I am wondering (and worrying) whether the constant pumping against the chest wall involves the ribs and if it will eventually wear out the muscle tissue or thicken it. I also wonder whether it is causing the heart to have to work harder.

You've almost answered your own question.

The fact that the heart muscle movement is visible may or may not be a problem depending on how much free movement is available on the chest wall and probably more importantly how tight the diaphragm is which can also limit heart movement.

If you look at somebody who is skinny, you can sometimes see heart beat movement on the chest too.

As long as there's enough space in the heart cavity, he should be fine.

Doctors are reluctant to do a repair job on this condition because invariably there's complications with the diaphragm (which is similarly why doctors are reluctant to surgically repair a hiatus hernia). Moreover, the outcome is often not a significant medical improvement when attempting to repair "cosmetic" cases.

So, the bottom line is that you need to keep an eye on the condition ... if it starts showing other symptoms like shortness of breath, palpatations, arrhytmias (skipped beats), or chest pain, then it absolutely needs further checking.

If you want further reassurance, then maybe a second opinion from another doctor, such as a cardiologist, might be a good idea.

When you can see the heart beating or feel it with your hands, clearly, do they mean the heart is hitting the chest wall or the rib cage?

remember that the heart muscle itself sits in a sac which provides a buffer for the heart muscle.

Generally, pectus excavatum means that the heart and lung capacity will be slightly below average but this will not affect day-to-day living. If the heart and lung capacity is reduced it may mean that the heart may not be able to pump well enough to maintain strenuous activities.

All that said, even serious cases of pectus excavatum are not life threatening. Running out of breath or fatigue, the two symptoms of heart/lung capacity being reduced are in effect making the heart issues self limiting.

If your friend isn't showing significant symptoms, then it's time to stop worrying!

Common problems that people with pectus deformities have are self confidence, and fear of doom. Self confidence is obvious because of appearance. Fear of doom is understandable, and I don't mean to sound harsh, but your worry for your friend will not be helping him here. He needs to be reassured that this condition is NOT life threatening.