Pectus carinatum (carinatum = ridge or keel) is a congenital deformity with protrusion of all or part of the anterior chest wall. This may be symmetrical but usually is asymmetrical.


Synonym: pigeon breast


Types of deformity:

(1) chondromanubrial - protrusion of the upper sternum

(2) xyphoidal - protrusion at the xyphoid process

(3) "pouter pigeon breast (Ravitch) - chondromanubrial protrusion over upper chest and retraction (excavatum deformity) over the lower part


Clinical features:

(1) Some cases are familial.

(2) Most patients are male.

(3) The chest shows a narrow lateral width and there is a reduced respiratory excursion.

(4) The patient may complain of:

(4a) shortness of breath on exertion with tachypnea

(4b) reduced endurance during exercise

(4c) exercise-induced wheezing

(5) About a third of patients have mild to moderate scoliosis.

(6) Embarrassment or psychological distress


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