Pectus excavatum is a common, congenital deformity of the anterior chest wall. It results in easily recognisable chest x-ray findings:

• blurring of right heart border
• increased density of the inferomedial lung zone
• horizontal posterior ribs
• vertical anterior ribs (heart shaped)
• displacement of heart towards the left
• obliteration of the descending aortic interface

Differential diagnosis includes:

• right middle lobe consolidation/atelectasis
• left para-aortic soft tissue density (e.g. mass)
• mediastinal mass due to deformation of the cardiomediastinal contour