Pectus carinatum

What is pectus carinatum ?

Pectus carinatum is a protrusion deformity of the anterior chest wall. The term is derived from the Latin phrase for „chest with keel“. Other terms for the deformity include chicken breast, pigeon chest, pyramidal chest, thorax cuneiform, or sternal kyphosis. There are two main types of pectus carinatum deformity:

Chondrogladiolar prominence — Chondrogladiolar prominence, also known as chicken breast or keel chest, is the most common type of deformity. The middle and lower portions of the sternum protrude and arch forward. The costal cartilages are concave and usually symmetrically depressed, accentuating the sternal prominence. The deformity is asymmetric in 30 to 50 percent of cases. Infrequently, patients can have a combined pectus carinatum on one side of the chest and pectus excavatum on the other.

Chondromanubrial prominence — Chondromanubrial prominence, also known as Pouter pigeon breast, is a more complex and substantially less common form of pectus carinatum deformity, representing about 5 percent of cases. In this form, the upper portion of the sternum protrudes anteriorly, and the body of the sternum is deviated posteriorly. A final anterior deflection of the distal sternum gives the characteristic Z-shape to the sternum on a lateral view.

It occurs four times more often in boys than in girls and typically becomes more pronounced during the early growth spurt of adolescence.

What causes pectus carinatum?

No one knows exactly what causes the deformity. It is more common in children who have connective tissue disorders, such as Marfan syndrome, and congenital heart disease. About 25 percent of people affected with pectus carinatum have a family history of chest wall deformities so genetic factors likely play a role in some cases.

What symptoms does it cause?

Pectus carinatum can cause a variety of symptoms, including chest pain, shortness of breath, difficulty exercising and asthma symptoms. Patients may also experience psychological distress and negative body image.

How is pectus carinatum treated?

There are many treatment options for pectus carinatum, including non-surgical bracing (dynamic compression system) and surgery (Ravitch technique). With our expertise in chest wall deformities, we can help you select the best treatment option for your child based on his or her specific needs.