Do you have a protruding chest? Let's talk about Pectus Carinatum

Is your child a little hesitant to wear a T-shirt or go to a swimming pool? Have you ever felt like the middle bone of his chest is sticking out a little more than usual? Or, are you reading this article suffering from this condition? Don't worry. We medically call this condition Pectus Carinatum . Many people also call it "pigeon chest". Today, we will talk about all the questions that are on your mind about this in a simple and friendly way.

What exactly is Pectus Carinatum?

Simply put, this is the protrusion of the flat bone in the middle of our chest, the sternum. Many people call it "pigeon chest" because it looks like the chest of a pigeon.

This is the other side of another condition. Some people you've seen have their chests sunken in. We call that Pectus Excavatum. So Pectus Carinatum is the other side of that, which is the chest protruding forward.

Are there any main types of this?

Yes, doctors divide it into two main types and several subtypes. Knowing this is important when deciding on treatment options.

You don't need to think too much about these classifications. When you see a doctor, he will examine your condition and tell you exactly which category you fall into.

How common is this condition?

According to statistics, approximately one in 1,000 people have this condition. However, some studies suggest that it may be even more common, perhaps as few as one in 300 people.

It is more common in males than females. Although the condition is present at birth, it often becomes more apparent and noticeable during the teen years , when children's bodies are growing rapidly.

What are the symptoms? Is this dangerous?

Here's the important thing. Most people with pectus carinatum have no symptoms . That is, they don't feel any discomfort other than a change in the appearance of their chest. A very small number of people may experience chest pain during certain activities or when they are in certain positions.

Why is this happening? What are the reasons?

Researchers haven't found a specific cause for this, but they believe it's caused by an abnormal growth of the cartilage that connects our ribs to the middle of our chest. Simply put, that cartilage grows too quickly, pushing the chest bone forward.

Is there a genetic link to this? Although a specific gene has not yet been identified, it is believed that there may be one. This is because about 33% of people with this condition, or about one-third, have a family history of this type of chest wall abnormality.

Also, pectus carinatum can occur in conjunction with other medical conditions. This does not mean that everyone with these conditions will develop a pigeon chest, but there may be a connection.

• Marfan syndrome: This is a disease that affects the connective tissues of the body.
• Noonan syndrome: This is a genetic condition.
• Scoliosis: A curvature of the spine.
• Asthma
• Bronchitis: Inflammation of the bronchial tubes.
• Mitral valve prolapse: A slight weakness in one of the heart valves.

Are there any other problems that could arise from this?

As mentioned earlier, even if there is no major physical problem, this condition can cause other problems. These can be very detrimental, especially for someone of a young age.

• Self-esteem issues: You may feel embarrassed or anxious about your appearance. You may be hesitant to take off your T-shirt, go swimming, or play with friends.
• Bad posture: You may automatically get into the habit of hunching over because you're trying to hide your chest bulge.
• Back pain: This incorrect posture can cause back pain over time.

How does a doctor diagnose this exactly?

If you have any doubts about this, the best thing to do is to see a doctor. He will be able to diagnose this condition very easily.

1. Obtaining a medical history: You and your parents will be asked about this.

2. Physical examination: The chest will be examined. They may also check for scoliosis.

3. Tests if necessary: ​​This can usually be diagnosed through a physical examination. However, to determine the severity of the condition and if surgery is being considered, some tests may be ordered to look at the condition of the internal organs of the chest.

• Chest X-ray: X-rays are taken from the front and side to look at the position of the bones.
• CT Scan (Computed Tomography - CT scan): This is also a special type of X-ray.
• MRI scan (Magnetic Resonance Imaging - MRI scan): A method of obtaining detailed images of the inside of the body without using X-rays.

What are the treatments?

Since this is not a dangerous condition, treatment is not necessary unless there is a major problem with appearance. However, if there is concern about appearance or if there is minor discomfort, there are effective treatments for this. There are two main methods.

Wearing a brace (Bracing)

This is like a brace that is worn around the chest.

• How does it work?: This brace applies pressure to the protruding bone in the chest from the front and back. Over time, that pressure causes the bone to gradually move back into its normal position.
• How to use: It can be worn under or over clothing. It is recommended to wear it for about 24 hours a day. It can be removed when bathing or playing sports.
• Who is it best for?: This method is most effective during a child's growing years . That is, when they are young. This is because at that time the bones and cartilage of the chest are still flexible. Therefore, it is easier to adjust to the pressure of the brace. It can be worn for anywhere from 6 months to several years.

Surgery

If a brace is not effective, or if an older person needs treatment, surgery may be considered.

• Ravitch procedure: In this procedure, the surgeon makes a small incision in the middle of the chest and removes the overgrown cartilage. The sternum is then moved back into its normal position and held in place using various methods (sutures, metal plates, or a bar).
• Minimally invasive surgery: This is similar to the Nuss procedure. Here, small incisions are made on either side of the chest, a metal bar is inserted, and the protruding bone is clamped in place. The bar is left in place for a year or more, and then removed through another minor operation.

Both of these methods are now very advanced and safe. Your surgeon will explain to you which method is best suited for your situation.

Are there any side effects or complications of the treatment?

• Wearing the brace: This is a very safe method. Sometimes the areas where the brace presses against the skin may become slightly red and scratched. If this happens, you can stop using the brace for a while and ask your doctor to adjust it properly.
• Surgery: As with any major surgery, there are some risks. However, these are generally safe and successful surgeries. Possible complications include:
• Pneumothorax (collapsed lung)
• Bleeding
• Fluid accumulation around the lungs (Pleural effusion)
• Inflammation of the membrane surrounding the heart (pericarditis)
• Infections
• The support used to fix the bone is broken.
• Recurrence

How long does it take to heal?

After surgery, you will be in the hospital for one to five days. You will have a follow-up visit with your surgeon in a few weeks. Your doctor will advise you when you can return to normal activities.

When should I see the doctor?

This is very important. There are several times when you or your child should see a doctor.

• If you feel chest pain or discomfort.
• If the appearance of your breasts has reduced your self-confidence, caused you to feel anxious, or made you feel reluctant to socialize .
• If this situation has interfered with your daily life in any way.

What questions should you ask the doctor?

When you go to see the doctor, don't forget to ask these questions.

• "Doctor, is a brace or surgery best for my condition?"
• "If I have to wear a brace, how many hours a day and for how long will I have to wear it?"
• "What are the typical results of the brace or surgery?"
• "If there's a problem with the brace, can you come quickly to fix it?"
• "How long does it take to fully recover after surgery?"

Living with this kind of change at school and with friends can be difficult at times. But remember, you are not alone. Don't keep this to yourself. Talk to your parents, a trusted adult, or your doctor. With the right advice and treatment, this condition can be managed well.

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