Barrel Chest: Causes, Symptoms, Diagnosis, and Treatment

What Is a Barrel Chest?

Barrel chest or barrel chest deformity refers to a rounded appearance of the chest that almost resembles a barrel. The typical anatomy of the chest is oval-shaped, with a lateral diameter lesser than its anteroposterior diameter. The chest index, the ratio of the anteroposterior diameter to the lateral diameter of the chest, is normally between 0.70 to 0.75. However, in the case of a barrel chest, this index increases to greater than 0.9; the lateral diameter gets bigger than or equal to the anteroposterior diameter. The ribs become relatively more horizontal, and dorsal kyphosis (outward rounding of the spine) is typically present. Although barrel chest is not a disease, it is a symptom of a number of other illnesses that can affect adults and children.

What Causes a Barrel Chest?

Barrel chest deformity occurs due to the lungs becoming overfilled with air. Barrel chests usually develop due to chronic lung diseases. However, other ailments and physiologic conditions can also cause barrel chest. Common conditions that can cause a barrel chest include; chronic obstructive pulmonary disease (COPD), asthma, cystic fibrosis, emphysema, and arthritis. In addition, certain genetic conditions can also cause barrel chest, and aging is another causative factor.

What Are the Symptoms Associated With Barrel Chest?

Symptoms associated with barrel chest are:

• Rounded and expanded appearance of the chest.

• Difficulty in breathing.

• Wheezing (refers to whistling sound while breathing).

• Cough.

• Gasping for air.

• Presence of phlegm (lung mucus).

• Bronchitis (swelling in the bronchial tube lining).

• Shortness of breath (dyspnea).

• Stiffness of the chest.

• Ribs become tender.

• Soreness of the back.

• Reduced blood oxygen level.

• Elevated carbon dioxide levels.

What Are the Conditions Associated With Barrel Chest?

Conditions associated with barrel chest are as follows:

1. Asthma: Asthma is a prevalent lung condition; about 7.8 percent of the United States population has asthma. It occurs when the airway passage constricts due to inflammation. The most frequent cause of a barrel chest in both children and adults is asthma. In cases of severe asthmatic airway obstruction, the lungs may overexpand and form a barrel-shaped chest. Some kids with severe asthma might have sunken-in bellies. This is a result of the muscles surrounding and beneath the lungs having to exert more effort to allow air into the lungs.

2. COPD (Chronic Obstructive Pulmonary Disease): The term "chronic obstructive pulmonary disease" (COPD) refers to a variety of lung conditions that develop when the lungs' airways become obstructed. This may occur as a result of lung damage, such as inflammation, scarring, and mucus, as well as other issues. Wheezing, trouble breathing, dyspnea, and barrel chest are COPD symptoms.

3. Emphysema: One of the most common causes of barrel chest is emphysema, a form of COPD. Emphysema causes the lungs and the bones surrounding them to remain in an overly inflated state by destroying lung tissue and trapping air inside the lungs.

4. Cystic Fibrosis: Children and young adults who have cystic fibrosis frequently develop a barrel chest. Cystic fibrosis is a hereditary condition that is potentially life-threatening, and it affects the lungs, digestive system, and other organs. Cystic fibrosis is characterized by the thickening of the mucus in the lungs. It may become difficult to breathe because of the heavy mucus clogging the lungs. A person may develop barrel-chest deformity as they struggle to breathe.

5. Arthritis: A barrel chest may result from arthritis in the rib, back, and chest wall joints. Although it rarely occurs in kids, this is more prevalent in older individuals. It occurs when the back and ribs become so tense or inflamed that they become trapped in an open or inhaled position.

6. Genetic Conditions: Certain genetic disorders can also lead to barrel-chest deformity; these include Dyggve-Melchoir-Clausen syndrome, sialidosis, and Spondyloepiphyseal dysplasia tarda.

Which Diagnostic Tests Are Done in Case of a Barrel Chest?

A barrel chest is diagnosed in the following ways:

• Physical Examination: The healthcare professional can identify the barrel chest through a physical examination because it is a visible side effect of a disease.

• X-Ray: X-rays of the front and back may be advised to confirm the presence of barrel-chest deformity in an individual.

• Lung Function Tests: To determine how well the patient's lungs are functioning if they have an underlying lung problem, the doctor may advise lung function tests like spirometry.

• Blood Examinations: Blood examinations may be done to check the oxygen and carbon dioxide levels in the blood. It may also be done to assess inflammation.

How Is a Barrel Chest Treated?

• Barrel chest does not have a specific treatment, although for many people, fixing the underlying medical issue can greatly improve barrel chest. The management of symptoms and preventing further progression are the primary goals of treatment. Treatments for barrel chests will differ depending on the underlying cause, but it is crucial to reduce inflammation and facilitate breathing.

• Emphysema and osteoarthritis patients may minimize the look of a barrel chest through pulmonary rehabilitation, medicine, and mild exercise, but these treatments cannot completely reverse the condition.

• Moreover, COPD is a chronic condition; any harm done to the lungs, ribs, or sternum cannot be restored.

• To minimize swelling in the lungs and joints, the doctor may also suggest anti-inflammatory drugs and a particular diet. Yoga, stretching, and other forms of exercise therapy may also be beneficial.

• People with barrel chests may find that treating the underlying problem makes their chest look better in certain instances, but the condition is typically permanent.

Conclusion:

The barrel chest is a rounded, protruding chest resembling a barrel. The most common causes of barrel chest in adults are lung disease and lung injury, but certain genetic, environmental, and aging-associated factors may also be a cause of the condition. It can be caused by various lung diseases, including chronic obstructive pulmonary disease (COPD), asthma, cystic fibrosis, emphysema, and arthritis. Barrel chest is a clinical feature of several conditions and not a disease in itself. It typically manifests in the advanced stages of conditions like emphysema, COPD, and asthma and must be considered a potential sign of serious lung damage.