Patient Tool · Pectus Excavatum

Haller Index self-assessment
Estimate the depth of your chest at home

The Haller Index is a simple ratio doctors use to describe how deep a pectus excavatum (sunken chest) is — the width of the chest divided by its depth at the deepest point. Because you can’t reach behind your own chest to measure that depth directly, this tool works it out in a doable way: measure your overall chest height, then subtract how deep the dip is. It is an educational estimate only, not a diagnosis — the true index is measured on a CT or MRI scan.

How to take your measurements

Chest cross-section showing width A, chest height C, and dip depth D measurements used for the Haller Index

Lie flat on your back on a firm surface (floor or table), breathing gently and normally.
Width (A): stand a rigid book or board upright against each side of the chest and measure the distance between them.
Chest height (C): measure straight up from the surface to the top of the raised ridge beside the dip.
Dip depth (D): rest a ruler flat across the two ridges and measure straight down to the deepest point of the dip.

Your depth at the deepest point is B = C − D, and the index is A ÷ B.

Enter your numbers

Width — A (side to side) widest point across the chest

Chest height — C (surface to ridge) table up to the raised ridge

Dip depth — D (ruler to bottom) ruler across ridges, down to deepest

Please enter all three measurements as positive numbers. The dip depth must be less than the chest height, and the width must be greater than the remaining depth.

—

your estimated Haller Index (width ÷ depth, where depth = C − D)

≤ 2.5
typical

2.5 – 3.25
mild–moderate

> 3.25
severe

Because the Haller Index is a ratio, you get the same result whether you measure in centimeters or inches — just use the same unit for both.

Please read: This is an estimate only. The true Haller Index is measured inside the chest on a CT or MRI scan, so your home number may differ from a clinical one. The reference ranges above (typical ≤2.5, mild–moderate 2.5–3.25, severe >3.25) are general guides, not a diagnosis, and a number on its own does not decide whether any treatment is needed. Use this to notice changes over time and to help you talk with your doctor. If you have any concerns about your chest, breathing, or heart, please speak with a healthcare professional. Whether surgery is appropriate — and whether it is covered by OHIP — is assessed by Dr. Irshad using your CT imaging at a consultation.

What is the Haller index?

The Haller index (sometimes called the pectus index) is the standard number doctors use to describe how severe a pectus excavatum is. On a single cross-sectional CT or MRI image at the deepest point of the chest, the inside width of the chest is divided by the shortest distance from the back of the breastbone to the front of the spine. The deeper the dip, the smaller that distance becomes, so the index goes up.¹

Haller index	What it usually means
About 2.5 or less	Typical chest shape. In people without pectus excavatum the index averages about 2.5.¹
2.5 – 3.25	Mild to moderate pectus excavatum.
Above 3.25	Severe pectus excavatum. A value above 3.25 is the traditional threshold used as one of the criteria when surgery is being considered.^1,2

The number is only part of the picture. Symptoms such as shortness of breath or chest pain with exercise, pressure on the heart, lung function testing, and how much the chest shape affects you all matter. A Haller index on its own does not decide whether surgery is needed.

Haller index on a CT scan vs. at home

A CT or MRI measures the depth inside the chest, from breastbone to spine. A home measurement can only use the outside of the chest, so the two numbers will not match exactly. The home estimate is useful for tracking change over time and starting a conversation with your doctor; the scan result is what is used to plan treatment.

Frequently asked questions

What is a normal Haller index?

About 2.5 or less. In people without pectus excavatum, the Haller index averages around 2.5.

What Haller index is considered severe?

A Haller index above 3.25 is traditionally considered severe and is one of the criteria used when surgery such as the Nuss procedure is being considered. Symptoms, heart and lung findings, and the patient’s own concerns are weighed alongside it.

How is the Haller index calculated?

The Haller index is the inside width of the chest divided by the shortest distance from the back of the breastbone to the front of the spine. Both are measured on a CT or MRI image at the deepest point of the chest.

Can I measure the Haller index at home?

You can estimate it with the calculator above using three simple chest measurements. It is an approximation only; the true Haller index is measured on a CT or MRI scan.

References: 1. Haller JA Jr, Kramer SS, Lietman SA. Use of CT scans in selection of patients for pectus excavatum surgery: a preliminary report. J Pediatr Surg. 1987;22(10):904–906. 2. Kelly RE Jr, Goretsky MJ, Obermeyer R, et al. Twenty-one years of experience with minimally invasive repair of pectus excavatum by the Nuss procedure in 1215 patients. Ann Surg. 2010;252(6):1072–1081.

Medically reviewed by Dr. Kashif Irshad, MD, MSc, FRCSC · Last updated August 2026

Think you may benefit from an assessment?

A referral from your family doctor or specialist is all that’s needed to be seen by Dr. Irshad, who reviews your imaging and discusses your options.

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