Pectus Carinatum: What You Need to Know

What is pectus carinatum?

Pectus carinatum is a chest deformity where the sternum (breastbone) sticks out too far. It is sometimes called “bird chest” or “pigeon chest” because of the protrusion of the sternum. The condition happens because of abnormal growth of cartilage (tough, connective tissue) on the ribs and sternum.

Pectus carinatum is a congenital birth defect (a condition present at birth) that becomes more noticeable as your child grows and goes through puberty. It is more common in boys than girls. 

The condition can be thought of as the opposite of pectus excavatum, another chest deformity where the sternum looks sunken or scooped-out. Read more about pectus excavatum here.

What are the symptoms of pectus carinatum?

Aside from the appearance of the chest, many children with pectus carinatum have no other symptoms. More severe cases may cause symptoms such as:

• Chest pain
• Shortness of breath
• Difficulty playing or exercising

What causes pectus carinatum?

Doctors aren’t sure why some babies are born with pectus carinatum. Some cases are hereditary (passed down in families), but many occur at random.

The deformity is sometimes a symptom of other disorders, such as Marfan syndrome or Ehler’s-Danlos syndrome, which affect connective tissue in the body.

How is pectus carinatum diagnosed?

The condition is diagnosed with the following tests:

• A physical examination. A doctor will evaluate your child’s symptoms and the appearance of the chest to determine if they have pectus carinatum.
• If necessary, a doctor might use a chest X-ray to determine the severity of your child’s pectus carinatum.

 The doctor will also check if your child’s pectus carinatum is a symptom of another condition. 

How is pectus carinatum treated?

Many mild cases do not need treatment, but many children and parents still seek to improve the appearance of the chest through bracing and surgery. If your child’s pectus carinatum causes symptoms or self-consciousness, the following treatments are available: 

• Bracing for pectus carinatum is an option for children under the age of 18. Your child must wear a chest brace beneath their clothing for up to 24 hours a day. The brace stays on for several months to several years, depending on the severity of your child’s pectus carinatum. Many children see significant improvement in the appearance of their chest within one year of bracing. The brace can be removed for showering and physical activity.
• The Ravitch procedure is a surgery for pectus carinatum. During the operation, your child will be put to sleep under general anesthesia while a doctor removes the extra cartilage from their chest area. Steel bars are sometimes placed beneath your child’s sternum to help the chest hold its shape.
• Some children may also feel self-conscious of the unusual shape of their chest. If your child struggles with self-esteem because of their pectus carinatum, ask their doctor about speaking with a mental health provider.