Healthy Living

What Is a Barrel Chest?

What Is a Barrel Chest?

Barrel Chest

A barrel chest refers to an individual's chest that appears to be always partially inflated. It looks as if they are taking a deep breath with their rib cage broadened. An individual with a barrel chest may find it hard to breathe.

A barrel chest may develop due to osteoarthritis or chronic obstructive pulmonary disease (COPD). Medical treatment may not always be required, but when a barrel chest is caused by COPD, then prompt treatment is needed for the condition. 

Have a question aboutChest Injuries and Disorders?Ask a doctor now

When it comes to fitness, a barrel chest means an expanded chest size due to bodybuilding. In this case, a barrel chest may be desirable. However, this concept is totally opposite in medical terms. In medical literature, the term barrel chest is typically used to describe a finding, which suggests a clinical process, and is a term used in clinical papers and textbooks.

What does it actually mean?

The rib cage system, which encloses the heart and lungs, dictates the shape of the chest. From the back to the lungs, the ribs are at an angle downward sloping. In rare cases, the orientation of the rib cage is not at a downward angle but in the horizontal position, which gives the appearance of a barrel-like shape.

An individual with a barrel chest has a rounded and bulging chest. It is not a disease, but a sign of an underlying medical condition, which is mostly related to osteoarthritis.

Osteoarthritis can make the joints stiff, especially those that are attached to the spine. The ribs tend to become fixed in an expanded position leading to a barrel chest appearance. 

This particular physical presentation is a common occurrence in some populations. A good example would be people who live in the Himalayas and the Andes, which is above 15,000 feet or 5,000 meters. In these areas, people tend to develop a barrel chest to cope with the high altitude and increased red blood cell count, which gives them more available oxygen and delivery. 

When it comes to bodybuilders, they usually work out to build up their pectoral muscles, which eventually lead to the appearance of a barrel chest. 

A barrel chest is also associated with emphysema, which eventually causes the following conditions: 

  • Weight loss
  • Chronic cough
  • Malaise
  • Pursed lip breathing
  • Accessory muscle use
  • Tachypnea
  • Clubbing of the nails
  • Peripheral cyanosis

Conditions Associated with a Barrel Chest

In an adult, a barrel chest may either be associated with osteoarthritis or COPD. However, in children, it may be associated with chronic asthma or cystic fibrosis.

1. Chronic Obstructive Pulmonary Disease (COPD)

COPD is a group of respiratory diseases, which include chronic bronchitis and emphysema. These lung conditions tend to get worse over time if the symptoms are not managed well. According to the National Heart, Lung, and Blood Institute, the third leading cause of death in the US is COPD. It has been estimated by the National Emphysema Foundation that 11.2 million people in America have COPD, and the number of people diagnosed with emphysema is around 3.1 million. 

If a person has COPD, breathing becomes difficult because the lungs are damaged in different ways:

  • The ability of the different parts of the lungs to stretch reduces or it becomes difficult for the lungs to expand and contract.
  • The alveoli wall and air sacs where oxygen and carbon dioxide exchange takes place are damaged.
  • Through the lungs, the airways are swollen and irritated since the airways gets clogged due to extra mucus.

To resemble a barrel, the area of the chest may change its shape, and the key muscle responsible for the movement of air in and out is the diaphragm. It becomes weaker and its length and thickness are also lost. If there is an improper functioning of the lungs, then deep breathing and exhaling air completely become difficult. Most of the time, the lungs remain inflated and the rib cage is in its expanded form. In the later stages of COPD, a barrel chest can be caused by a state of hyperinflated lungs.

2. Emphysema

Emphysema is a type of COPD that can also cause a barrel chest. After physical activity, the two major signs and symptoms of emphysema are shortness of breath and chronic cough. Other symptoms may include:

  • Higher oxygen rate at rest
  • Breathing difficulty
  • Ability to do exercise becomes limited
  • Severe breathlessness
  • High levels of blood carbon dioxide

Although COPD and emphysema do not have any cure, individuals with these respiratory conditions can benefit from lifestyle changes and proper symptom management. These changes include:

  • Quitting smoking
  • Using supplemental oxygen or inhalers
  • Regular exercise
  • Medications
  • Healthy eating habits

3. Osteoarthritis

Osteoarthritis is a degenerative joint disorder that is characterized by the breakdown, inflammation, and cartilage loss in the joints. It is a type of arthritis that slowly develops and most frequently occurs in adults. The most frequently affected areas are the spine, hips, hands, and knees, which swell and become stiff.

A barrel chest may develop when osteoarthritis affects the rib cage that meets the spine. The flexibility of the rib joint will be lost and it will become stiff. It will look as if in the out position the ribs are stuck.

The chest wall may become rigid due to osteoarthritis of the ribs and spine. Other signs and symptoms are joint swelling, severe joint pain after exercise, morning stiffness, and impaired movement.

4. Cystic Fibrosis

A barrel chest is another sign of cystic fibrosis in children. Cystic fibrosis is a genetic condition, which produces abnormally thick and sticky mucus that can clog the lungs and affect other organs in the body. 

In most cases, more than 75 percent of children with cystic fibrosis are diagnosed when they reach the age of 2. Frequent infection and lung damage may occur due to mucus in the lungs, which leads to the appearance of a barrel chest. Studies have shown a strong link between the development of a barrel chest and hyperinflated lungs in children with severe asthma cases. Moreover, a slow growth rate has been observed in children with a barrel chest.

Treating a Barrel Chest When You Have COPD

There is no specific treatment for a barrel chest. Doctors often treat the underlying condition to help reduce the appearance of an expanded rib cage and chest. 

Follow your doctor’s instructions on medications, therapy, and exercise if you want to reduce the appearance of an expanded chest. Talk with your doctor if the appearance of your chest bothers you.

Other Possible Causes

  • Dorsal Kyphosis - With increased age, the calcium content of the bones also decreases and causes the bones to weaken and break. In this condition, the rib cage and breastbone becomes deformed and creates a rounded back. 
  • Asthma - The chest may expand due to asthma and may become barrel-shaped in children. In asthma, the airways become persistently narrow, which makes it hard for children to properly breathe. After exhalation, it can cause trapping of the air, which causes a barrel chest. A barrel chest typically develops in individuals with chronic asthma. 
  • Chronic Bronchitis - It may cause cyanosis, tachypnea, productive cough, wheezing, accessory muscle use and prolonged expiratory time.
  • Genetic Disorder - Infants can also develop a barrel chest due to rare genetic disorders. In such cases, it is considered as a congenital abnormality of the skeletal system.
  • Upper Body Strength - Men with broad, powerful, and rounded chests are described to have a barrel chest. Such people have a lot of upper strength.
  • Acromegaly - It is a rare hormonal disorder, wherein the pituitary gland secretes excessive amounts of growth hormone during adulthood. For this reason, the bones may abnormally increase in size.