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Pectus carinatum

Pigeon breast; Pigeon chest

 

Pectus carinatum is present when the chest protrudes over the sternum. It is often described as giving the person a bird-like appearance.

Considerations

 

Pectus carinatum may occur alone or along with other genetic disorders or syndromes. The condition causes the sternum to protrude. There is 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 a normal heart and lungs. However, the deformity may prevent these from functioning as well as they could. There is some evidence that pectus carinatum may prevent complete emptying of air from the lungs in children. These young people may have less stamina, even if they do not recognize it.

Pectus deformities can also have an impact on a child's self image. Some children live happily with pectus carinatum. For others, the shape of the chest can damage their self-image and self-confidence. These feelings may interfere with forming connections to others.

 

Causes

 

Causes may include:

  • Congenital pectus carinatum (present at birth)
  • Trisomy 18
  • Trisomy 21
  • Homocystinuria
  • Marfan syndrome
  • Morquio syndrome
  • Multiple lentigines syndrome
  • Osteogenesis imperfecta

 

Home Care

 

No specific home care is needed 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

 

The provider will perform a physical exam and ask questions about the child's medical history and symptoms. Questions 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 present?

Tests that may be done include:

  • Lung function testing to measure how well the heart and lungs are performing
  • Lab tests such as chromosome studies, enzyme assays, x-rays, or metabolic studies

A brace may be used to treat children and young adolescents. Surgery is sometimes done. Some people have gained improved exercise ability and better lung function after surgery.

 

 

References

Boas SR. Skeletal diseases influencing pulmonary function. In: Kliegman RM, Stanton BF, St Geme JW III, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 417.

 
  • Ribcage - illustration

    The ribs connect on the front of the chest with the long flat sternum, or breast bone, and on the back with the vertebral column, creating a cage of protection for the lungs and heart.

    Ribcage

    illustration

  • Bowed chest (pigeon breast) - illustration

    A bowed chest is also called pectus carinatum. It is a protrusion of the chest over the sternum often described as bird-like. Pectus carinatum is usually only a cosmetic defect but can be associated with other genetic diseases.

    Bowed chest (pigeon breast)

    illustration

    • Ribcage - illustration

      The ribs connect on the front of the chest with the long flat sternum, or breast bone, and on the back with the vertebral column, creating a cage of protection for the lungs and heart.

      Ribcage

      illustration

    • Bowed chest (pigeon breast) - illustration

      A bowed chest is also called pectus carinatum. It is a protrusion of the chest over the sternum often described as bird-like. Pectus carinatum is usually only a cosmetic defect but can be associated with other genetic diseases.

      Bowed chest (pigeon breast)

      illustration


     

    Review Date: 7/10/2015

    Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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