What is a Barrel Chest?

Rounding of the chest may be a sign of a disease, or of the aging process.

Lung function test by using Triflow. Jan-Otto/ GettyImages

People with a "barrel chest" have a chest and rib cage that's rounded and bulging out—in fact, the chest looks somewhat like a barrel (hence the name).

There are a number of possible causes for barrel chest, including arthritis and just plain aging. But it's also common in people suffering from advanced chronic obstructive pulmonary disease.

In COPD, a barrel chest occurs when your lungs are overinflated with air, so your rib cage stays partially expanded as if you're always breathing in deeply.

It has also been described as occurring as a result of weight loss and muscle wasting in the late stages of COPD. So, the diameter of the chest (from front to back) appears bigger than the diameter of the abdomen (from front to back). 

You won't be diagnosed with a barrel chest since it's not an actual disease—rather, it's a symptom of a disease or of the aging process. But since it's quite obvious, your doctor may notice it when conducting a physical exam and may mention it to you.

Overview of A Barrel Chest in COPD

When you have chronic obstructive pulmonary disease, you have trouble breathing because your air passages are blocked by mucus or inflammation. When this occurs, you can't always exhale all the air you breathe in—some of it may become trapped in your lungs.

A barrel chest may result from this trapped air. The air keeps your rib cage expanded (as if you were drawing a very deep breath) without allowing it to deflate as it normally would when you breathe out.

Ultimately, your rib cage (which is supposed to be wider at the sides and narrower in the front and back) will expand at the front and back, and begin to resemble that of a barrel.

This doesn't usually occur in the early stages of COPD. Instead, you're more likely to experience it in the later stages when you're also experiencing other symptoms of late-stage COPD, such as constant shortness of breath during everyday activities (for example, getting dressed and using the bathroom).

Treating Barrel Chest When You Have COPD

There's no treatment that specifically targets barrel chest. Instead, your doctor will want to get the underlying cause of barrel chest (your chronic obstructive pulmonary disease) under better control. Doing that may help reduce the barrel-like appearance of your expanded chest and rib cage.

If you want to help reduce the size of your expanded chest (and hopefully breathe better, as well), your best bet is to follow your doctor's instructions on medications, exercise, and therapy for your COPD. If the appearance of your chest bothers you, talk about it with your doctor.

Other Possible Causes of Barrel Chest

It's important to understand that COPD isn't the only cause of a barrel chest.

For instance, arthritis may cause a person to develop a barrel chest. This occurs because the joints in your rib cage—which attach the rib cage to your spine—become less flexible and eventually remain mostly in the "deep breath" expanded position.

As people age too, there is a decrease in the calcium content of the bones which may result in bone weakening and breaks. This can cause deformity of the rib cage and breastbone, and create a rounded back (called dorsal kyphosis).

A barrel-shaped chest may then appear, as a result of these structural alterations.

Severe asthma may also cause your chest to expand into that noticeable barrel shape, even in children. In this case, treatment may allow the lungs to deflate fully and permit the rib cage to expand and contract normally again.

Also, some rare genetic disorders may cause a baby to have a barrel chest—in these instances, it's considered a skeletal abnormality and is congenital.

Finally, you may have heard people use the term "barrel chested" to describe someone (usually a man) with a chest that's broad, round, and powerful-looking.

Men who look like this often have plenty of upper-body strength.

Sources:

Bonomo L. Larici AR, Maggi F, Schiavon F, Berlett R. Aging and the respiratory system.  Radiol Clin North Am. 2008 Jul;46(4):685-702.

Centers for Disease Control and Prevention. (2015). Birth Defects Surveillance Toolkit

Tokuda Y, Miyagi S. Physical diagnosis of chronic obstructive pulmonary disease. Intern Med. 2007;46(23):1885-91.

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