Sunken chest syndrome: NHS U-turn call for ‘depressed’ patients

Image copyright Kerry Van Der Merwe

A woman who suffered years of mental health issues because of sunken chest syndrome has called on the NHS to make the corrective operation routine again.

Kerry Van Der Merwe, 45, of Devon, was diagnosed with depression aged 16.

Twelve surgeons are challenging NHS England after it stopped the routine surgery last year, claiming patients have been clinically depressed.

Sunken chest syndrome is a malformation of the chest wall caused by the breastbone sinking inwards.

Ms Van Der Merwe had corrective surgery in February after her doctor argued she needed it to fix a previous operation in South Africa.

She said as a teenager she would “would hide away quite a lot”.

“I didn’t want to be with anyone, I never smiled, I was odd and I had no confidence whatsoever,” she said.

“My friends would ask me: ‘How come you’ve got a hole in your chest?’

“I could never swim or undress in front of others. I became scared of people.”

Image copyright Kerry Van Der Merwe

Ms Van Der Merwe said GPs’ dismissal of her condition as a purely cosmetic one contributed to her anxiety as she felt like she “didn’t have a voice”.

She said surgery “helped her massively” as her heart was now in the right place, her chest was straight and she no longer had palpitations or breathlessness.

“Having the operation for me was crucial,” she said.

Previously, the NHS in England said it had stopped offering routine surgery for those with the condition because there was insufficient evidence the benefits of surgical treatment warranted funding.

Ms Van Der Merwe urged the NHS to put surgery “back on the table” as “you cannot put a price on mental health”.

Pectus excavatum

Image copyright Science Photo Library

• The NHS defines it as a malformation of the chest wall caused by the breastbone sinking inwards. It affects more males than females and it may be inherited
• Symptoms include chest pain, breathlessness, fatigue, dizziness and a fast heart rate
• According to the NHS, pectus has little psychological impact on the patient but it can sometimes cause distress “leading to concerns about appearance, withdrawal and social isolation”
• In most cases it presents itself at birth but only becomes noticeable during puberty
• The condition can be treated with the Nuss procedure, which involves the placing of one or more metal bars to correct the abnormal shape of the chest. The bars stay in place for two to three years

Sources: NHS, British Lung Foundation

Dr Ian Hunt, 52, who works at St George’s Hospital in London, is leading a 12-strong group of surgeons challenging NHS England’s decision to stop routine surgery for those with sunken chest syndrome.

He said the NHS would only look at the physical impact of the condition instead of assessing patients “holistically”.

Dr Hunt said some of his patients have been “traumatised” by the condition, with some becoming clinically depressed.

He said providing surgery for the most serious cases would ultimately save the NHS resources as it would make it “much less likely” for patients to need mental health treatment in the future.

“I am often taken aback when we’ve corrected their chest – they come back and they’re different people,” he said.

“It’s just a recognition of how psychological wellbeing is important in terms of health.”

The NHS has been approached for a comment on the latest calls for surgery to resume.