Barrel Chest

A barrel chest is when you have a broad, rounded chest that looks like a barrel. It happens when too much air fills your lungs or when air pockets build up in the hollow space in your chest (thoracic cavity).

When most people breathe, muscles help the rib cage extend out (expand) when they breathe in and shrink (contract) when they breathe out. But sometimes, aging and some lung conditions cause air to build up in your lungs or chest. This causes your rib cage to puff out like a barrel and stay in the extended position.

What are the most common causes of barrel chest?

Common barrel chest causes include:

• Aging: As you get older, you lose some muscle mass, and your lungs get less stretchy. This can cause your chest to look rounded.
• Arthritis: Over time, arthritis can make your ribs so stiff that they stay expanded.
• Asthma: Long-term inflammation narrows your airways. In a severe asthma attack, your lungs may overinflate.
• Chronic obstructive pulmonary disease (COPD): This describes many conditions that damage your lungs and airways, making breathing difficult. Over time, it can cause your chest to overinflate.
• Cystic fibrosis: An inherited (genetic) condition that causes mucus to build up and block your organs. It can affect your airways, lungs and other organs.
• Emphysema: This is when damage to your lung sacs (alveoli) causes a blockage, which traps air in your lungs.
• Other bone and connective tissue conditions: Brittle bone disease, Marfan syndrome, pectus carinatum, scoliosis and other conditions can affect the shape of your chest.

What are the symptoms?

If you have a barrel chest, you may have other symptoms like:

• Back or chest pain
• Changes to how you sit or stand (posture changes)
• Coughing or wheezing
• Difficulty breathing
• Feeling very tired (fatigue)
• Inflammation and mucus in your windpipe and bronchi (bronchitis)
• Sore ribs
• Shortness of breath

Does it hurt?

No, a barrel chest doesn’t hurt. But some of the conditions that cause a barrel chest may cause discomfort or pain.

How is a barrel chest treated?

There’s no specific treatment for a barrel chest. Treatment involves identifying and treating the cause. This may help reduce a barrel chest. But in most cases, once your rib cage extends out from a chronic condition, it’s usually permanent. Treatments may include:

• Lifestyle changes: Quitting smoking, maintaining a healthy weight for you and getting regular physical activity can help strengthen your lungs. They can also help slow down COPD symptoms and reduce mucus production.
• Medications: Bronchodilators, corticosteroids and anti-inflammatory drugs can help treat asthma and COPD. Antibiotics can help treat emphysema.
• Oxygen therapy: In severe cases, you may need gas or liquid oxygen to help your body function.
• Pulmonary rehabilitation: Healthcare providers teach you exercises and techniques to help strengthen your lungs and manage conditions like asthma, COPD and cystic fibrosis. Some techniques can help you expel trapped air that can contribute to a barrel chest.
• Surgery: In severe cases where your lungs don’t respond to other treatments, you may need a lung transplant. A lung transplant replaces your damaged lungs with the healthy lungs of a donor.

What are the possible complications of not treating it?

A barrel chest isn’t dangerous. But it indicates you may have issues with your lungs, muscles or bones that can cause breathing problems. If you don’t treat the cause, you may develop problems like:

• Collapsed lung (pneumothorax)
• Heart problems
• Respiratory infections, including pneumonia
• Scarring in your lungs or airways

Can it be prevented?

You can help reduce your chances of developing a condition that causes a barrel chest by:

• Avoiding things that can damage your lungs, like tobacco products, secondhand smoke, poor air quality, chemical fumes and allergens
• Testing your home for radon gas
• Wearing a mask or other personal protective equipment (PPE) when you’re around chemicals, secondhand smoke or in areas with a lot of dirty air

When should a barrel chest be treated by a healthcare provider?

Get medical attention right away if you have a barrel chest and:

• Breathing problems
• Chest pain or tightness
• Unexplained weight loss
• Your chest shape looks bigger or rounder than usual