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Pectus Carinatum – Symptoms, Risk Factors and Treatment

What is Pectus Carinatum?

Pectus Carinatum is a rare and genetic deformity of the chest wall. It makes the breast-bone (sternum) bulge out and results in the appearance of a pigeon, hence the name pigeon chest. 

What Should You Know About Pectus Carinatum? 

Pectus Carinatum or pigeon chest is a birth defect, but it is not noticeable till the child reaches puberty. It starts during the development of the chest wall. The abnormal outward growth of the cartilage that connects the ribs results in pectus carinatum. Although not very common, affects more boys than girls. 

Pectus carinatum is often asymmetrical, with affecting one side of the chest more than the other. Besides, few children have pectus carinatum on one side of the chest with an indentation known as pectus excavatum on the other side of the chest.

Approximately 15 per cent of children with it develop scoliosis.

The incidence of pectus carinatum is four times higher in boys than in girls. Pectus carinatum affects the appearance of the child, who may feel short of breath during physical activities. Treatment of pigeon chest is possible with surgeries and the use of braces.

What are the Symptoms of Pectus Carinatum?

The appearance of symptoms of pectus carinatum can be  late, and you may notice the bulging out of the chest bone only as the child reaches puberty. The following symptoms may be present during early childhood or infancy:

  • Rapid breathing
  • Asthma
  • Pain or tenderness in the cartilage having abnormal growth
  • Irregular depression in the chest

You may also notice the following symptoms as the child grows:

  • Chest pain
  • Broad chest with a thin appearance
  • Recurrent respiratory infections
  • Irregular curvature of the spine
  • Shortness of breath after strenuous physical activities

What are the Risk Factors for Pectus Carinatum?

Pectus Carinatum is a genetic disorder and is more prevalent in children with other genetic conditions:

  • Marfan syndrome: a connective tissue disorder
  • Ehlers-Danlos syndrome: connective tissue disorder affecting the skin, blood vessels, and joints
  • Noonan syndrome: a disorder that affects the normal development of different parts of the body
  • Morquio syndrome: It affects physical abilities
  • Metabolic conditions, such as homocystinuria 
  • Brittle bone disease: a genetic disorder that affects healthy bone development 
  • Cardiofaciocutaneous syndrome: abnormalities of the face, hair, and head
  • Chromosomal abnormalities

When to See a Doctor for Pectus Carinatum?

Consulting a doctor at an early stage of pectus carinatum may help early initiation of the treatment. Visit a physician if the child has asthma, recurrent respiratory tract infections, shortness of breath, and chest pain for an assessment.

Consulting a doctor for pectus carinatum is also necessary to detect associated abnormalities as this condition has multiple risk factors. 

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What are the Treatment Options for Pectus Carinatum?

Most cases of pectus carinatum require treatment to correct the deformity and enhance the appearance of the child.

  • Orthotic bracing: Bracing is an ideal treatment for mild-to-moderate cases of pectus carinatum. They place the braces on the chest. These braces exert pressure on the site with deformity and help flatten the chest bone for a normal appearance. 
  • Surgical option: The doctor may suggest surgery if bracing does not help. Surgery is also suitable for individuals with severe symptoms that are affecting overall health and growth. Doctors remove the cartilage and reposition the breast bone during the surgery. 

Conclusion

Pectus carinatum is a genetic disorder that causes deformity of the chest wall. It results in an abnormal appearance and can cause several symptoms. Your child may not require any treatment if the condition is mild and is not affecting the appearance. Doctors may consider the use of bracing or surgery to treat severe cases of pectus carinatum.

Frequently Asked Questions (FAQs)

Are there different types of pectus carinatum?

There are two types of pectus carinatum. In Chondrogladiolar prominence also known as the Chicken Breast condition, the bulging occurs in the middle and lower portions of the breast bone. In Chondromanubrial prominence or Pouter pigeon breast , the breast bone  develops in a complex shape of the Z alphabet with the top section pushing forward. . It is rarer than chicken breast pectus carinatum.

How does bracing therapy work in pectus carinatum?

Bracing therapy can be helpful during the growth stage of bones and if the child’s chest is flexible enough. It will be of no use after the complete formation of chest bones. The child has to follow a painstaking schedule of wearing braces. Braces are tailor-made as per the measurements of your child’s chest. Periodic adjustment may be necessary to accommodate the child’s growth.

Can pectus carinatum worsen as the child grows?

Pectus carinatum is a rare condition that does not manifest until puberty. It can become worse during the growth phase.

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