What Is the Life Expectancy of Someone With Pigeon Chest?

Pigeon chest, also known by its medical name pectus carinatum, is a moderately rare congenital condition that causes the sternum to stick out. In some cases, the protruding chest looks similar to the shape of a bird’s breast, hence giving this condition its common name, pigeon chest. 

Due to its appearance, it can cause considerable stress and worry for parents, particularly in more severe cases. Consequently, it is important to be informed about the potential problems and consequences of pectus carinatum. 

What Is Pectus Carinatum?

Pectus carinatum is a congenital deformity of the chest wall in which the breastbone (sternum) protrudes outward. It is present from birth but is usually not obvious until puberty. Pectus carinatum arises from a predisposition for excessive cartilage growth forming the breastbone. This pushes the breastbone forward, giving the characteristic “pigeon chest” appearance. 

Pigeon chest varies widely in its causes, severity, and presentation. It is sometimes associated with another syndrome or condition, such as Marfan syndrome, Noonan syndrome, and others. In other patients, it appears in isolation from other conditions (known as “isolated pectus carinatum”). 

It is a relatively rare condition, affecting about one in every 1500 people[1], and occurs approximately four to five times more frequently in males than females.[2,3] 

Can Your Child Live With Pectus Carinatum?

Yes, most children with pectus carinatum can live a regular life with proper treatment. No treatment may be required in the mildest cases of pectus carinatum. However, most children suffering from this condition benefit from some form of treatment. The recommended treatment option for most children is bracing, which applies pressure to the chest region and trains the breastbone cartilage to grow into the desired shape. The benefits of this method are that it is non-invasive and carries minimal risk. 

The other treatment option is surgery, which is generally invasive and carries a higher risk, although the aesthetic outcome may be more effective than bracing. Surgery is usually only recommended as the first-line treatment method in very severe cases of pectus carinatum. 

Consequently, most children can enjoy a regular life after suitable treatment. 

Does Pectus Carinatum Affect Your Child’s Life Expectancy?

In most cases, pectus carinatum will not significantly decrease or affect life expectancy. In mild cases, pectus carinatum will have minimal effects on everyday physiological functioning and no effect on lifespan. However, in more severe cases, pectus carinatum may lead to problems with the functioning of the heart and/or affect breathing. Surgical treatment is recommended in these cases, which carries its own level of risk and potential complications. However, after successful surgical treatment, 

In patients with another condition that causes the pectus carinatum, it is important to differentiate between problems caused by and those caused by pectus carinatum. Pectus carinatum itself is not life-threatening, but the other condition involved (e.g., trisomy 18, Morquio syndrome) may cause significant problems and reduce life expectancy. 

In summary, pectus carinatum itself is not likely to affect your child’s life expectancy. Nearly all individuals with isolated pectus carinatum are able to enjoy a normal and fulfilling life. 

What Problems Can Pectus Carinatum Cause?

Pectus carinatum can cause some or all of the following side effects, even in mild to moderate cases: 

• Poor posture, such as having hunched shoulders or always bending forward
• Curvature of the spine (scoliosis or kyphosis)
• Always feeling fatigued
• Shortness of breath
• Tachycardia (having an unusually fast heart rate)
• Chest pain

Another common side effect of pectus carinatum is rib flaring, where the lower ribs are pushed outward or “flared.” This can also contribute to poor posture and difficulty breathing. Fortunately, rib flaring can also be successfully treated using orthotic bracing. 

In addition to these common problems, pectus carinatum can cause a number of psychological issues and physical issues. These are outlined in the following sections. 

Psychological Issues

The psychological impact is an important aspect of pectus carinatum that should not be overlooked. Children and teenagers who suffer from this condition can often experience social isolation, anxiety, and depression. Due to the appearance of their chest, most individuals with pectus carinatum will be very self-conscious, and many will avoid activities requiring them to take their shirt off - most commonly swimming or gym class. Pectus carinatum can lead to challenges in social and personal relationships and even academic or professional difficulties. 

One study found that body image and mental quality of life were significantly lower in patients with pectus carinatum compared to the general population.[4] However, it is important to note that their body image did not affect their physical quality of life. Furthermore, treating pectus carinatum with bracing or surgical interventions significantly improves the body image of people with this condition.[4,5]

Physical Issues

In more severe cases, pectus carinatum can cause more serious physical problems, and these should not be ignored, as pectus carinatum will not improve over time. In some patients, chest compression (due to the expanded breastbone cartilage) can impact heart and lung function. 

One study found that 22% of individuals with severe pectus carinatum experienced asthmatic symptoms, while all experienced shortness of breath. Furthermore, 11% of individuals reported experiencing recurrent sinus infections.[6] Another study, which included a broader spectrum of mild, moderate, and severe patients, reported that 33% showed some cardiopulmonary symptoms, while 61% showed postural symptoms.[4]

While many patients show tachycardia (a fast heart rate), this is usually to compensate for reduced lung capacity. Patients may rarely experience more severe cardiovascular problems, such as valve malfunction or partial obstructions [7]. Some patients also show mitral valve disease; however, many of these cases are due to associated congenital heart disease rather than being caused by pectus carinatum directly.[8] 

In summary, severe cases of pectus carinatum without treatment may lead to significant physical problems with the heart and/or lung function, which could impact life expectancy. However, if treated, these problems are usually successfully resolved. 

Conclusion

Do you want to find out more information about treating your child’s pectus carinatum with bracing? Here at Dakota Brace, our aim is to provide the best possible treatment for pectus carinatum at an affordable cost. Click here to arrange a free consultation with one of our health professionals and $75 off your first order!

References

1. Robicsek F, Watts LT. Pectus carinatum. Thorac Surg Clin. 2010;20:563–74.
2. Cobben, J. M., Oostra, R. J., & van Dijk, F. S. (2014). Pectus excavatum and carinatum. European Journal of Medical Genetics, 57(8), 414-417.
3. Abdullah F, Harris J (2016) Pectus excavatum: more than a matter of aesthetics. Pediatr Ann, 45:e403–e406.
4. Steinmann, C., Krille, S., Mueller, A., Weber, P., Reingruber, B., & Martin, A. (2011). Pectus excavatum and pectus carinatum patients suffer from lower quality of life and impaired body image: a control group comparison of psychological characteristics prior to surgical correction. European Journal of Cardio-Thoracic Surgery, 40(5), 1138-1145.
5. Orrick, B. A., Pierce, A. L., & McElroy, S. F. (2022). Changes in self-image after pectus carinatum brace treatment. Journal of Pediatric Surgery, 57(8), 1579-1583.
6. Fonkalsrud, E. W. (2008). Surgical correction of pectus carinatum: lessons learned from 260 patients. Journal of Pediatric Surgery, 43(7), 1235-1243.
7. Iakovlev, V. M., Nechaeva, G. I., & Viktorova, I. A. (1990). Clinical function of the myocardium and cardio-and hemodynamics in patients with pectus carinatum deformity. Terapevticheskii Arkhiv, 62(4), 69-72.
8. Croitoru, D., & Nuss, D. (2004). Chest wall anomalies: pectus excavatum and pectus carinatum. Adolesc Med, 15, 455-471.