Understanding Pectus Carinatum: Causes, Symptoms, and Treatment Options

This blog post will give insight into understanding pectus carinatum: causes, symptoms, and treatment options.

Pectus carinatum, also known as “pigeon chest,” is a chest deformity characterized by a protrusion of the sternum and ribs. Its counterpart chest deformity is Pectus Excavatum (also known as “sunken chest”). 

The condition can occur in males and females but is more common in males. 

Pectus Carinatum Causes

The exact cause of pectus carinatum is primarily unknown. However, several theories have been proposed. One theory is that it is caused by an overgrowth of the cartilage that connects the ribs to the breastbone (sternum). This overgrowth can cause the sternum to be pushed outwards, leading to the characteristic protrusion. Another theory is that a combination of genetic and environmental factors causes it. 

Studies have shown that there is a hereditary component to the condition, with a higher incidence in families with a history of pectus carinatum.

Here are some fast Facts on Pectus Carinatum from Medical News Today

  • PC (pectus carinatum) affects around 1 in every 1500 children.
  • The condition affects four times as many males as females.
  • Pectus carinatum (aka Pigeon chest) is the second most common chest abnormality seen in children.

Symptoms of Pectus Carinatum 

The most apparent symptom of pectus carinatum is the protrusion of the sternum and ribs. However, the condition can also cause other symptoms. These can include:

  • Shortness of breath
  • Chest pain
  • Fatigue
  • Rapid heartbeat
  • Palpitations
  • Difficulty exercising

Some of the above symptoms could indicate a more serious underlying condition, but are not always present, and many people with pectus carinatum do not experience any symptoms (other than aesthetic). 

Treatment Options for Pectus Carinatum 

The treatment options for pectus carinatum will depend on the severity of the condition and the symptoms experienced. The most common treatment options include:

  • Observation: For mild cases of pectus carinatum, close observation may be recommended. The condition may improve on its own as the child grows.
  • Bracing: A custom-made brace can be worn to push redirect cartilage overgrowth into place to a normal appearance. Bracing is a popular non-invasive treatment option with effective results. This treatment is most effective in children and adolescents. Depending on the severity of the PC, bracing typically needs to be worn either part time or full-time on a daily basis for about three months for improvement to be seen. Off-the shelf braces may often not give the same results as a custom made solution. 
  • Surgery: Pectus carinatum can be surgically repaired through an operation. The surgeon will make an incision in your child’s chest wall to remove the cartilage wedged between the ribs and sternum, and from there will reposition and reshape the sternum. A bar will be left in the chest wall to maintain the correct shape for a period of time (which could be six months to a year). During this time, your child must refrain from activities that can cause a collision, like rugby. 
  • Physical therapy: After surgery, physical therapy can be used to help the patient regain strength and range of motion in the chest and back muscles.

As a parent it is important to understand all treatment options, and “If non-invasive treatment is available, why put your child under the stress of invasive chest wall surgery?” Rowan Berkowitz


It is important to note that the majority of children who are diagnosed with PC are able to live normal lives. If the case is mild to moderate, there may be a possibility that no medical treatment will be necessary. 

While pectus carinatum can be noticeable due to the protrusion, it is not life-threatening. It can, however, cause physical and psychological distress, particularly in adolescents and young adults. For children requiring medical intervention like bracing, results can usually be seen within a couple of months (when worn as prescribed and appropriately designed), and they have high satisfaction rates after seeing the results. If your child is experiencing symptoms of pectus carinatum or has a noticeable protrusion, it is essential to consult a specialist to diagnose and prescribe the best treatment options.