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Pectus carinatum
Definition
Pectus carinatum describes a protrusion of the chest over the sternum, often described as giving the person a bird-like appearance.
Alternative Names
Pigeon breast; Pigeon chest
Considerations
Pectus carinatum may occur as a solitary abnormality or in association with other genetic disorders or syndromes.The condition causes the sternum to protrude, with a narrow depression along the sides of the chest. This gives the chest a bowed-out appearance similar to that of a pigeon.
People with pectus carinatum generally develop normal hearts and lungs, but the deformity may prevent these from functioning optimally. There is some evidence that pectus carinatum may prevent complete expiration of air from the lungs in children. These young people may have a decrease in stamina, even if they do not recognize it.
Apart from the possible physiologic consequences, pectus deformities can have a significant psychologic impact. Some children live happily with pectus carinatum. For others, though, the shape of the chest can damage their self-image and self-confidence, possibly disrupting connections with others.
Causes
- Congenital pectus carinatum (present at birth)
- Trisomy 18
- Trisomy 21
- Homocystinuria
- Marfan syndrome
- Morquio syndrome
- Multiple lentigines syndrome
- Osteogenesis imperfecta
Home Care
No specific care is indicated for this condition.
When to Contact a Medical Professional
Call your health care provider if you notice that your child's chest seems abnormal in shape.
What to Expect at Your Office Visit
A brace may be used to treat children and young adolescents.
The health care provider will perform a physical exam and ask questions about the patient's medical history and symptoms. Question may include:
- When did you first notice this? Was it present at birth, or did it develop as the child grew?
- Is it getting better, worse, or staying the same?
- What other symptoms are also present?
Pulmonary function testing may be useful to determine the impact of the deformity on the performance of the heart and lungs. Laboratory studies such as chromosome studies, enzyme assays, x-rays, or metabolic studies may be ordered to confirm the presence of a suspected disorder.
Surgery is a possible treatment option. There have been some reports of improved exercise ability and improved lung perfusion scans after surgery.
References
Boas SR. Skeletal diseases influencing pulmonary function. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 411.
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
