Pectus Carinatum is the second most common chest wall deformity, commonly known as ‘pigeon chest’. Like Pectus Excavatum, Pectus Carinatum is most likely caused by abnormal overgrowth of the costal cartilage between the ribs and sternum causing the sternum or breastbone to stick out. Rather than growing flat along the chest wall, the costal cartilages grow outward pushing the sternum forward. It is a condition where the central bone of the chest protrudes
This appearance is most noticed in later childhood and becomes more prominent during adolescence. Pectus Carinatum is most often seen in adolescents and usually in males and continues until skeletal maturity is reached. Skeletal maturity usually occurs around 18 years of age. Although the shape of the chest wall is distorted, it does not usually affect the internal organs. Pectus Carinatum is almost always treated with a brace, and not with surgery.
Specialist Screening Healthcare Ireland’s PectusCheck service provides access and education regarding the T-Joe Pectus Bracing System which is the leading custom-made brace design system used by physicians worldwide for Pectus Carinatum conditions. PectusCheck will identify and diagnose your Pectus Carinatum by offering both a consultant thoracic specialist opinion combined with specialist investigative diagnostic tests (if clinically indicated) specifically tailored to Pectus Carinatum conditions.
For most individuals, they will have no symptoms of Pectus Carinatum and are asymptomatic apart from the visible chest deformity.
In general, individuals with Pectus Carinatum who do not have symptoms may never need treatment. Physical therapy such as breathing exercises and aerobic activity may be advised.
Visible chest deformity
Pectus Carinatum is a visible deformity where the sternum or breastbone sticks out. Generally, a benign (not harmful) condition Pectus Carinatum in most cases is purely cosmetic in nature. Many patients seek cosmetic treatment options for Pectus Carinatum in order to correct the appearance of the chest.
Physical symptoms are uncommon however, in severe cases of Pectus Carinatum, the following physical and psychological symptoms can be present.
Shortness of Breath
Trouble breathing especially with physical exertion.
Reduced Exercise Tolerance & Stamina
Finding it harder to breathe, especially when exercising compared to peers due to reduced exercise tolerance and stamina.
Tenderness or Pain in the Area of Overgrowth at the Site of the Protrusion.
Some Individuals affected may report pain if the protrusion of the chest is squashed when asleep or knocked during daily activities or sport. Sometimes only one side is affected, making the chest asymmetrical (uneven).
Spinal Issues also Known as ‘Pectus Induced Spinal Curvature’
This occurs mostly when there is an asymmetric pectus defect, either excavatum or carinatum that produces uneven pressure onto the ribs, then around to the vertebrae and then causing them to bend or bow to the left or right side depending on where the Pectus is located.
In Pectus Excavatum / Carinatum as well as mixed deformities, rib flare can occur in the lower ribs where the ribs and the costal margin either on one (usually the left) or both sides are pulled upwards and stick out.
Poor Pectus Posture (Forward Head and Neck Posture)
There can be an altered centre of gravity particularly in protruding Pectus Carinatum conditions. The appearance of the head tends to be in a pushed forward position and the neck excessively flexed. This is partly due to the altered gravity caused by the Pectus defect in addition to the tight pectoralis muscles and weakened upper back muscles.
Shoulders (Uneven, Rounded & Scapula Winging)
The shoulders can be affected in several ways in patients with pectus deformities including uneven shoulder (shoulders appear to be at same level), rounded shoulders where the shoulders appear to drop forwards and winging of the shoulder blades (scapula winging) where the shoulder blades appear to protrude or look prominent.
Abdomen & Pelvis
Due to rib flaring together with the pelvis rotating forward forcing the spine to curve known as anterior pelvic tilt the abdomen can appear to be excessively protruding, sometimes known as a “pot belly”. Less common in patients with pectus deformities the posterior pelvic tilt, where the hips are excessively tilted forward or backward can also occur.
In some patients, Pectus Carinatum may be associated with Marfan syndrome a connective tissue disorder. If clinically indicated, PectusCheck can organise a referral to a specialist Marfan’s clinic.
Frequent Chest Infection
Chest infections that are repetitive and will not go away.
Fatigue or Extreme Tiredness
Fatigue is an excessive persistent feeling of extreme tiredness that may not be alleviated by sleep or rest. It can affect the way you think, including poor concentration and memory loss, as as make you feel more emotion than usual.
The following phycological symptoms of a pectus deformity can have a significant impact on activities of daily living. PectusCheck can organise a referral to a specialist psychologist if required.