Children with pectus deformities often tire sooner than their peers, due to shortness of breath and fatigue. This negatively affects gas exchange and causes a decrease in stamina. Thus, respirations are inefficient and the individual needs to use the accessory muscles for respiration, rather than normal chest muscles, during strenuous exercise.

In moderate to severe cases of pectus carinatum, the chest wall is rigidly held in an outward position. People with pectus carinatum usually develop normal heart and lungs, but the deformity may prevent these from functioning optimally. In about 25% of cases of pectus carinatum, the patient has a family member with the condition.Ĭlinical Presentation However, the condition may be present in association with other syndromes: Turner syndrome, Noonan syndrome, Loeys-Dietz syndrome, Marfan syndrome, Ehlers-Danlos syndrome, Morquio syndrome, trisomy 18, trisomy 21, homocystinuria, osteogenesis imperfecta, multiple lentigines syndrome (LEOPARD syndrome), Sly syndrome (mucopolysaccharidosis type VII), and scoliosis. Pectus carinatum is generally a solitary, non-syndromic abnormality.

Least common is a pectus carinatum deformity following open-heart surgery or in children with poorly controlled bronchial asthma. Pectus carinatum can also be caused by vitamin D deficiency in children (Rickets) due to the deposition of unmineralized osteoid. As the child reaches age 2 or 3 years of age, the outward sternal protrusion becomes more pronounced. The condition may be evident in newborns as a rounded anterior chest wall. The second most common is the presence of pectus carinatum at or shortly after birth. Some parents report that their child's pectus carinatum seemingly popped up overnight. Most commonly, pectus carinatum develops in 11-to-14-year-old pubertal males undergoing a growth spurt. It primarily occurs among four different patient groups, and males are more frequently affected than females. Pectus carinatum is an overgrowth of costal cartilage causing the sternum to protrude forward. Barrel chest deformities with increased anteroposterior (AP) chest diameters can be seen in obstructive forms of chronic pulmonary disease, such as cystic fibrosis and untreated or poorly controlled asthma. Many affected patients have no physical complaints however, concerns about body image have been associated with low self-esteem and a decreased mental quality of life. Cosmetic concerns can be significant factors in opting for correction. Some develop rigidity of the chest wall with decreased lung compliance, progressive emphysema, and increased frequency of respiratory tract infections. Hippocrates described the carinatum deformity as a 'sharply pointed chest' and reported that patients became 'affected with difficulty breathing.' Symptomatic patients report dyspnea and decreased endurance. Pectus carinatum is a term used to describe a spectrum of protrusion abnormalities of the anterior chest wall. The deformity may be classified as either chondrogladiolar or chondromanubrial, depending on the site of greatest prominence.

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