Top Causes of Barrel Chest

It's common in COPD, but can be a side-effect of other conditions too

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

Barrel chest is just what it sounds like: A torso that appears rounded and bulging. Some people, usually men, are naturally broad across the chest. But for others, barrel chest can be a side-effect or result of a medical condition—in particular chronic obstructive pulmonary disease (COPD). Here's an overview of the most common causes of barrel chest.

Barrel Chest As a Symptom of COPD

In someone with COPD barrel chest can develop over time because the lungs remain overinflated with air, leaving the rib cage partially expanded. This happens because with COPD, the air passages are blocked by mucus or inflammation, making it difficult to exhale all of the air that's breathed in, leaving some trapped in the lungs. The air keeps the rib cage expanded (as if drawing a very deep breath) without allowing it to deflate as it normally would.

Ultimately, the 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 the shape of a barrel. A person who's in the very late stages of COPD also may become barrel chested as a result of weight loss and muscle wasting, causing the diameter of the chest (from front to back) to appear bigger than the diameter of the abdomen (from front to back).

Other symptoms of late-stage COPD in

There's no way to directly treat barrel chest. However, getting COPD under better control by carefully following all doctor's instructions regarding medication, exercise, and therapy can help to reduce the barrel-like appearance of an expanded chest and rib cage.

Other Possible Causes

Besides COPD, here are other common reasons a person's may develop a barrel chest:

Arthritis. Barrel chest can occur as a result of this degenerative joint diseased because the joints in the rib cage—which attach the rib cage to your spine—become less flexible. Eventually they can become stuck in a "deep breath" expanded position.

Low calcium. With age the amount of calcium in bones decreases, causing them to weaken and break easily. This can cause deformity of the rib cage and breastbone, and also cause a condition called dorsal kyphosis in which the back is rounded and hunched.

Severe asthma. Even children can develop barrel chest when they're unable to exhale fully due to asthma. Proper treatment can help to prevent this, however, by allowing the lungs to deflate fully and the rib cage to expand and contract normally.

Genetics. There are rare genetic disorders that can cause a baby to have a barrel chest, in which case it's considered a congenital skeletal abnormality. At the same time, some folks, usually men, are simply born with a chest that's broad and rounded. For them barrel chest is simply the way they're built and not the result of a medical condition.

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.