What is pectus carinatum?
Pectus carinatum is when part of the breastbone is pushed outwards or raised. It usually happens during a rapid growth spurt in children and adolescents aged 10 and older.
Pectus carinatum develops differently in different people. It can push forward the top, side, or bottom of the breastbone so it sticks out. It either develops in the same way on both sides (symmetrically) or occurs on just one side (asymmetrically). The breastbone can be either stiff or flexible.
How common is it?
Pectus carinatum is rare. It affects up to 2 in every 1,000 children and affects more boys than girls.
What causes pectus carinatum?
The causes of pectus carinatum are unclear:
- one possible cause is when the tissue that connects the breastbone to the ribs grows too much
- it can also happen when parts of the breastbone grow too much
- sometimes it happens following open-heart surgery.
Pectus carinatum seems to run in families. But it’s not known for sure if it’s an inherited condition. Sometimes pectus carinatum develops as part of a rare genetic disorder. People with disorders including Marfan syndrome and Noonan syndrome may have pectus carinatum.
Are there any complications?
Up to 1 in 10 people with chest conditions like pectus carinatum may also have scoliosis (curving of the spine). Most people with pectus carinatum don’t have any other medical problems.
If your child has pectus carinatum as part of a genetic disorder like Marfan syndrome or Noonan syndrome, they might have other symptoms caused by these conditions.
Pectus carinatum and body image
Because it affects the shape of their chest, some people with pectus carinatum may be unhappy with their bodies. This can have a big impact on their lives. Even if pectus carinatum isn’t causing any physical problems, health care professionals may recommend treatment to improve self-esteem and quality of life. Talk to your doctor or nurse if you’re worried about your own or your child’s wellbeing.
What are the signs and symptoms?
Most children with pectus carinatum do not have any symptoms other than their chest sticking out. This usually starts to develop at the age of 10 or older.
Some people with pectus carinatum may feel tenderness where the breastbone sticks out.
Some people may develop a stiff chest wall. They may experience breathlessness and find it harder to breathe, especially when they exercise.
How is pectus carinatum diagnosed?
Pectus carinatum can be diagnosed with a visual assessment. The doctor usually just needs to look at your child’s chest.
Some people may need an X-ray or CT scan so that the doctor or surgeon can see how their breastbone is growing.
They may have tests to check whether their heart is working properly and breathing tests to see how well their lungs are working.
They may have a blood test to rule out genetic causes such as Marfan syndrome and Noonan syndrome.
Will it get better by itself?
Pectus carinatum is unlikely to get better by itself. In some mild cases, weightlifting and exercise can build muscles in the chest, which can help to hide the shape of the breastbone.
What is the treatment?
Mild cases of pectus carinatum may not need treatment. When doctors or surgeons recommend treatment, it’s usually for cosmetic reasons or to improve self-esteem and quality of life. Treatment is not usually considered for children under the age of 10.
Orthotic treatment
People with moderate to severe pectus carinatum may have orthotic treatment. This means using special equipment to correct the shape of their chest.
A chest compression brace will need to be worn, which puts gentle pressure on the chest to change the shape and position of the breastbone over time. It is not clear if the brace permanently changes the breastbone.
The brace needs to be worn every day. Treatment may take up to two years depending on the person’s age at the time of treatment, how stiff the breastbone is, and the severity of the condition. For treatment to be effective, the brace must be worn exactly as directed. The more hours spent wearing the brace, the more likely it is to be successful.
Surgery
If your child’s pectus carinatum is more severe, they may need surgery. There’s more information about pectus correction surgery on the Royal Brompton NHS Trust website.
Is treatment available in my area?
Not every part of the UK offers orthotic treatment or surgery for pectus carinatum. You may have to travel to another area. Your doctor will refer you.
More help and support
Looking after a child with pectus carinatum can be difficult. It’s important you take time to take care of yourself, as well as your child. Talk to your doctor or nurse if you feel like you’re struggling to cope. You can always call our helpline – our friendly team can help answer your questions or worries. Call 0300 222 5800, Monday to Friday between 9am – 5pm (excluding Bank Holidays).
You may also want to join our Parent and Carer Support Network which provides support and a space for parents and carers of children with lung conditions to come together.