Patient Education

What is pectus carinatum?

Pectus carinatum is a deformity of your child's chest wall in which it is pushed outward. It’s often asymmetrical, with one side of the chest affected more than the other. In addition, some children have pectus carinatum on one side of the chest and an indentation called pectus excavatum on the other side of the chest.

What causes pectus carinatum?

The exact cause of pectus carinatum is not known. There is an abnormal growth of the bones and cartilage, but we don’t know why. It runs in families; in up to 25 percent of cases, there is someone else in the family who has it.

What are the symptoms of pectus carinatum?

While many children with the condition don’t experience any symptoms beyond a concern about their appearance, some children have the following symptoms:

• Difficulty breathing during exercise or other activities

• Frequent respiratory infections

• Asthma

When does pectus carinatum become apparent?

It can sometimes be seen in newborns and during early childhood. Most of the time, though, it doesn’t become apparent until your child is 11 or 12. It’s rare for the condition to show up after that.

Are there any medical complications associated with pectus carinatum?

It is often associated with other abnormalities of the muscles or skeleton, the most common being curvature of the spine, or scoliosis. It’s also associated with a number of rare musculoskeletal syndromes.

In rare cases, if pectus carinatum is present during infancy, it may be associated with premature fusion of the segments of the breastbone, a short wide breastbone, and congenital heart disease.

How serious is pectus carinatum?

The level of severity goes from almost unnoticeable to severe, but the condition does tend to get worse during growth spurts.

How is pectus carinatum diagnosed?

Your child's doctor can diagnose pectus carinatum by examining your child.

• The physician calculates the depth of the chest from front to back using X-rays of the chest to determine if the diameter is longer than average (if it is, that means your child has pectus carinatum).

• X-rays also help the doctor determine the presence of scoliosis or any other abnormalities of the bones.

  Other tests your child's doctor might recommend include:
  

• Electrocardiogram (ECG or EKG)—a test that records the electrical activity of your child's heart, shows abnormal rhythms and detects heart muscle stress

• Echocardiogram (echo)—a test that evaluates the structure and function of your child's heart by using sound waves recorded on an electronic sensor, which produces a moving picture of the heart and heart valves

• Computed tomography (CT) scan—a test that is used to establish the level of severity of the condition and also help the surgical team plan for the procedure

How is pectus carinatum treated?

Bracing can treat mild-to-moderate cases of the condition successfully if your child's chest is still flexible. Once the chest bones are completely formed, bracing becomes much less effective. In this case — or if your child cannot or does not want to follow the rigorous bracing schedule — your doctor may recommend a surgical procedure to correct his pectus carinatum.

Your child will need to wear the brace when he is at home and when sleeping at night. The process of correction will often take about a year. It's important to remember that how quickly the process occurs is directly related to how long and how consistently your child wears the brace. The most important factor in the successful treatment of pectus carinatum is your child's desire to get rid of the protrusion and improve the appearance of his chest.