Pectus Carinatum: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Pectus Carinatum?
A pediatrician, a doctor for children, or a primary care doctor often notices pectus carinatum first. A surgeon who treats chest wall problems may be involved if bracing or surgery is needed. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is pectus carinatum?
Pectus carinatum is a chest wall shape where the breastbone, called the sternum, sticks out. It is also called pigeon chest or pigeon breast. The chest looks bowed outward, like the chest of a pigeon. There is often a narrow dip along the sides of the chest.
It can happen alone or along with other genetic disorders. It is the second most common chest wall deformity after pectus excavatum, in which the chest looks caved in. People with pectus carinatum generally develop a normal heart and lungs. Still, the shape may keep them from working as well as they could. There is some evidence that it may stop children from fully emptying air from their lungs.
Symptoms
Many people have few symptoms besides the shape of the chest. Possible signs include:
- A breastbone that sticks out.
- Chest pain, mainly when sleeping on the stomach.
- Discomfort about how the chest looks.
- Less stamina, even if the person does not notice it.
The shape is often mild in childhood and becomes more obvious during the teen years. Because it can be seen through clothing, many teenagers want it corrected. The shape can also affect a child's self-image. Some children live happily with it. For others, it can hurt self-confidence.
Causes and who gets it
In many cases the cause is unknown. Doctors think it may come from overgrowth of the cartilage that joins the ribs to the breastbone. Genes may play a part. In up to 33% of patients, other family members also have a chest wall deformity.
It can also occur with other conditions, such as Marfan syndrome, Ehlers-Danlos syndrome, and osteogenesis imperfecta. It is seen about four times as often in males as in females.
How doctors diagnose it
A doctor does a physical exam and asks about your child's medical history and symptoms. Questions may include when the shape was first noticed, whether it was there at birth, and whether it is getting better or worse.
Tests that may be done include lung function testing, which measures how well the heart and lungs are working. Other tests may include x-rays, chromosome studies, enzyme assays, or metabolic studies. Doctors may use these to look for other genetic conditions.
Treatment
No specific home care is needed. A brace may be used to treat children and young adolescents. Bracing is often the first treatment. Success rates are above 70% when the brace is worn as directed. Pain, skin problems, shame, and discomfort can keep people from wearing it, which lowers success.
Surgery is sometimes done. It is a next step if bracing fails or if a person cannot use a brace, for example because of a rigid chest wall. One method is a minimally invasive repair called the Abramson procedure, which uses a bar placed in front of the breastbone. Some people gain better exercise ability and lung function after surgery. Surgery can also improve body image and quality of life.
When to see a doctor
Contact your health care provider if you notice that your child's chest seems abnormal in shape.
Also tell the doctor about low stamina, since the chest shape may keep the lungs from working as well as they could.
Call 911 or go to the emergency room for chest pain or discomfort that lasts two minutes or more, trouble breathing, or fainting.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can examine your child's chest, order tests, and refer you to a surgeon or other specialist. They can also follow your child's progress over time.
Common questions
Is pectus carinatum dangerous?
Usually not. People with pectus carinatum generally develop a normal heart and lungs, though the shape may keep them from working as well as they could. Many people mostly have concerns about how the chest looks.
Can a brace fix pectus carinatum?
Often yes. Bracing is often the first treatment, and success rates exceed 70% when the brace is worn as directed. Pain, skin problems, and discomfort can make people stop wearing it.
Does pectus carinatum cause chest pain?
It can. When symptoms occur, they often include chest pain, mainly when sleeping on the stomach, and discomfort about how the chest looks. Many people have fewer symptoms than people with pectus excavatum.
What is the difference between pectus carinatum and pectus excavatum?
Pectus carinatum is a breastbone that sticks out. Pectus excavatum is a breastbone pushed inward, so the chest looks caved in.
Sources
- MedlinePlus - Pectus carinatum
- PubMed Central - Pectus excavatum and carinatum: a narrative review of epidemiology, etiopathogenesis, clinical features, and classification
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
