Medically reperceived by Deborah Weatherspoon, Ph.D., R.N., CRNA — Written by Lori Smith, MSN, BSN, WHNP-BC on February 6, 2018

Pectus carinatum is a rare chest wall deformity that reasons the breastbone to push exterior instead of being flush versus the chest. It is additionally known as pigeon chest or keel chest.

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When the chest wall establishes, the cartilage that connects the ribs typically grows level along the chest. In cases of pectus carinatum, this cartilage grows abusually, causing unequal expansion in the locations wbelow the ribs connect to the sternum. This reasons the outside appearance of the chest wall.

Many frequently, pectus carinatum creates during childhood and gets more pronounced as children go with puberty. In some cases, it may not be noticed until a child goes via their adolescent growth spurt.

In this write-up, we take a look at the symptoms associated via pectus carinatum, in addition to the feasible reasons and threat components. We additionally research the therapy options and also the outlook for this problem.


Symptoms

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Share on PinterestPigeon chest or pectus carinatum. Image credit: Tolson411, (2010, February 13)
Often, the pushing outside of the breastbone is the just symptom that a perkid experiences.

Some people might report other symptoms, such as:

shortness of breath, which is more widespread in the time of exercisetenderness or pain in the locations of abnormal cartilage growthfrequent respiratory infectionschest painrapid heart rate

In some youngsters, the appearance of pectus carinatum may be worse on one side, via the oppowebsite side appearing to have actually a dip in it. This dip is referred to as pectus excavatum.

The condition may also be associated via certain medical problems including:

kyphosis, where the back is hunchedvarious other musculoskeletal abnormalitiesabnormal development patterns
Types

Tright here are two various kinds of pectus carinatum:

Chondrogladiolar prominence: This form of pectus carinatum is also referred to as “chicken breast” and also is the a lot of prevalent create of the condition. Here, the middle and also lower sections of the breastbone push forward.Chondromanubrial prominence: This form of pectus carinatum is additionally called “Pouter pigeon breast” and is an extra rare and complicated form of the problem. Here, the breastbone creates in a Z-shape, via the optimal section pushing forward.
Causes and also threat factors
Share on PinterestPectus carinatum is normally diagnosed by taking an X-ray of the chest.

Pectus carinatum is brought about by the abnormal advancement of the cartilage that connects the ribs.

The precise cause is not known. The condition have the right to run in family members, but, so genetics may be a danger element.

Pectus carinatum occurs more generally in people who have actually certain hereditary conditions. These problems include:

Marfan syndromeEhlers-Danlos syndromemetabolic disorders, such as homocystinuriaMorquio syndromebrittle bone diseaseCoffin-Lowery syndromecardiofaciocutaneous syndromechromosomal abnormalities
Diagnosis

To diagnose pectus carinatum, a physician will have to research exactly how the breastbone is prospering. To carry out this, they will certainly most likely request a chest X-ray.

A medical professional might also request pulmonary function tests if the condition is causing respiratory symptoms. People who experience symptoms regarded the heart might also require an electrocardiogram or echocardiogram.

Computed tomography (CT) or magnetic resonance imaging (MRI) scans deserve to assist doctors in more significant instances. If a medical professional is considering surgery as a kind of treatment, these imaging tests have the right to aid via planning the operation.

Depending on the appearance of the pectus carinatum, doctors may also decide to test for connected problems, such as scoliosis, congenital heart disease, and Marfan syndrome.

If the son has not gone through puberty yet, the doctor may decide to wait before deciding on a course of therapy. Doing so enables them time to occupational out what the best strategy will certainly be.


Treatment

While some children and adolescents have the right to endure symptoms and also side impacts from pectus carinatum, the problem is mainly cosmetic. Treatment is based upon appearance as well as symptoms.

Bracing


Share on PinterestTreatment is usually a lot of reliable when the patient is a child or adolescent.

The standard treatment technique for pectus carinatum in children with a mild to moderate form of the condition is orthotic bracing. This involves a custom-fitted brace that fits on the outside of the chest.

The objective of the brace is to location press on the location the majority of influenced by the condition, to flatten it to the chest.

To see any type of impacts, a boy will certainly should wear a brace for at least 8 hrs a day for a number of months, according to doctor’s instructions. A child might should wear the brace till they have gone through puberty.

Surgery

Surgery is typically just an alternative for world when a chest brace has actually been ineffective or when they have passed puberty. A medical professional may also take into consideration surgical procedure for civilization whose symptoms are severe.

The Ravitch procedure is a surgical procedure that requires rerelocating the abnormal cartilage and also placing the breastbone in a normal place within the chest.

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In some situations, the surgeon will certainly have to break the breastbone so that they can reposition it accurately. Some people may require a metal chest bar temporarily placed across the inside of the chest and also wired to the ribs.