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What is a Barrel Chest? Understanding the Causes and Implications

Editorial Team
By
Updated Mar 03, 2024
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What Is a Barrel Chest?

Characterized by a rounded, bulging chest resembling a barrel due to a permanently expanded rib cage, the condition known as barrel chest is often a signal of underlying health concerns. According to the National Heart, Lung, and Blood Institute, conditions such as chronic obstructive pulmonary disease (COPD), which affects approximately 16 million Americans, can lead to this physical change. 

Moreover, the Global Initiative for Chronic Obstructive Lung Disease reports that COPD could become the third leading cause of death worldwide by 2030, underscoring the potential severity of the symptoms. 

While not a disease itself, understanding what is a barrel chest is crucial, as it may prompt necessary medical evaluation and management of the associated conditions, enhancing patient outcomes and quality of life.

Commonly associated with older men, barrel chest can also manifest itself in women and even children. Children who suffer from chronic asthma, cystic fibrosis, a connective tissue disorder, emphysema, or who are obese are most at risk. In many cases, children who develop this problem have chronic asthma and likely endure acute attacks of wheezing, coughing, and dyspnea or shortness of breath. Patients with chronic childhood or adult asthma suffer from airway inflammation that can result in unpredictable flare-ups that interrupt normal breathing. Asthma prevention and treatment commonly involves the use of inhalers like albuterol or other inhaled medications including corticosteroids and allergy medications.

Patients who have contracted COPD can develop an expanded ribcage during the later stages of the disease. COPD is one of the world’s leading causes of death and actually refers to a series of lung diseases, including chronic bronchitis and emphysema, that all cause airflow blockage, chest tightness, and difficulty breathing. One of the primary causes of COPD is a persistent smoking habit and, since lung damage is difficult to heal, treatment emphasizes the prevention of further damage and control of existing symptoms with inhalers or inhaled steroids. Severe cases may require oxygen therapy and surgical treatment.

Some men — and bodybuilders in particular — may seek to achieve the look of a barrel chest by strengthening the chest and back muscles, including the internal and external intercostals, the serratus anterior, and the pectoralis minor and major. The bench press, chest press, pushups, pullovers, swimming, yoga, Pilates, and the pectoral fly are all exercises that can help achieve the barrel chested look associated with male strength. Introducing variation in the angle, weight, sets, and repetitions of a chest exercise can help achieve the desired result more quickly.

What Causes a Barrel Chest? 

In a true barrel chest, the ribs become permanently fused in a position as if a deep breath has been taken.

Lungs that are over-inflated over long periods will push against the rib cage from the front and back, gradually reshaping it to a barrel shape. Since having a barrel chest can come from lung disease, symptoms associated with a barrel chest can include breathing difficulties, shortness of breath, and lower oxygen saturation. 

Arthritis in the ribs, back, and chest can cause the formation of a barrel chest. This happens when the ribs and back get so stiff and inflamed that they become stuck in an inhaling position due to loss of flexibility. Usually it is the wear and tear of osteoarthritis that causes a barrel chest.

A barrel chest can also occur due to genetic conditions and among populations in certain locations such as the Andes Mountains where the air is thin. Bodybuilders and yogis may also develop barrel chests from their exercise regimens.

Is Having a Barrel Chest a Serious Condition? 

Barrel chests aren’t serious as a symptom, but the causes of a barrel chest could be. Any breathing difficulties or fatigue in addition to a barrel chest should be reported to your primary care physician as they could be symptoms of life-threatening conditions. A barrel chest could be a symptom of emphysema, for example, and should be examined by doctors. 

Some people who live in higher altitudes, such as the Andes or the Himalayas, might naturally have barrel chests.

Can You Develop a Barrel Chest in Childhood? 

Children with severe asthma or cystic fibrosis can develop a barrel chest at a young age. Other children are born with barrel-shaped chests due to genetic conditions. Below we’ll look at some of the conditions which might produce a barrel chest. 

Dyggve-Melchior-Clausen Syndrome 

DMC is a rare genetic condition that progresses toward a deformed skeletal structure and an abnormally small head, or microcephaly. 

Sialidosis 

Patients with this rare condition have an abnormal accumulation of toxic substances in the body. Other symptoms include cognitive impairment, red spots on the eyes, enlarged tongue and gums, and shortness of breath.

Spondyloepiphyseal Dysplasia Tarda 

Symptoms of this condition appear between ages 6 and 10 and include spinal deformities, a barrel chest, and osteoarthritis, which usually only appears in adults. 

Are There Early Symptoms of Development of a Barrel Chest? 

The early signs of a barrel chest are usually the symptoms of lung disease such as emphysema. Labored breathing and fatigue, stiffness, and low oxygen saturation are among the symptoms that indicate both lung disease and the risk of developing a barrel chest.

How is a Barrel Chest Diagnosed? 

Often a barrel chest is diagnosed on sight, but doctors should use X-rays of the chest and back to confirm the condition. If diagnosed by a primary care physician, barrel chest patients may be referred to experts in pulmonology, genetics, or rheumatology, depending on what condition caused the barrel chest.

Can a Barrel Chest Be Reversed? 

Most often, once a barrel chest is developed, the condition is permanent. There’s no approved treatment for a barrel-shaped chest, although medical research on surgical repair of ribs is underway, and the field is constantly evolving. Scientists and doctors discover new treatments for various diseases every day.

Those who have barrel chests from lung conditions such as asthma or chronic obstructive pulmonary disease (COPD) may see the shape of their chests change when their lung conditions are treated.

Lung swelling can be treated with anti-inflammatory medications, and changes in diet and activities such as swimming can lessen the appearance of a barrel chest. 

The Bottom Line 

Developing a barrel chest isn’t dangerous, but the conditions that can cause a barrel chest are. Severe lung diseases such as asthma, chronic obstructive pulmonary disease, and cystic fibrosis can cause the lungs to overinflate and reshape the rib cage permanently. 

Other causes of a barrel chest range from rare genetic conditions in children to osteoarthritis in the ribs, back, and chest in older adults. 

While there is no approved treatment for barrel chest, care for the lung conditions that caused it can reduce the appearance of a barrel chest and improve pulmonary health.

FAQ on Barrel Chest

What is a barrel chest and what causes it?

A barrel chest is a condition where the chest appears rounded and bulging, similar to the shape of a barrel. It's often associated with chronic obstructive pulmonary disease (COPD) and other chronic respiratory conditions. These conditions lead to the overinflation of the lungs, which can cause the rib cage to stay expanded. According to the American Lung Association, COPD affects more than 16 million Americans, and barrel chest can be a physical manifestation of the disease's progression.

Can a barrel chest be a sign of an underlying health issue?

Yes, a barrel chest can be indicative of underlying health issues, particularly respiratory illnesses such as emphysema, chronic bronchitis, or severe asthma. These conditions can cause the lungs to overinflate and push on the rib cage. It's important to consult a healthcare provider if you notice changes in your chest shape, as it could signal a need for medical evaluation and potentially treatment for a chronic respiratory condition.

Is barrel chest hereditary or acquired over time?

Barrel chest can be both hereditary and acquired. Some individuals may have a naturally rounded chest shape due to their genetic makeup. However, more commonly, a barrel chest is acquired over time due to chronic respiratory diseases like COPD. Long-term exposure to lung irritants, such as tobacco smoke, air pollution, or occupational dust and chemicals, can lead to these diseases and consequently to the development of a barrel chest.

Can exercise or physical therapy help reduce the effects of a barrel chest?

While exercise or physical therapy cannot change the structure of a barrel chest once it has formed, they can help improve respiratory function and overall fitness. Pulmonary rehabilitation, which often includes exercise training, can enhance the quality of life for individuals with chronic lung conditions. The American Thoracic Society highlights the benefits of pulmonary rehabilitation, including improved exercise capacity and symptom management for those with COPD.

Are there any treatments available for barrel chest?

Treatment for barrel chest focuses on managing the underlying respiratory condition. This may include medications such as bronchodilators, steroids, and oxygen therapy. In some cases, surgery may be considered to reduce lung volume and improve breathing mechanics. Lifestyle changes, such as quitting smoking and avoiding lung irritants, are also crucial. It's essential to work with a healthcare provider to determine the best treatment plan based on the individual's specific condition and health needs.

TheHealthBoard is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
Editorial Team
By Editorial Team
Our Editorial Team, made up of seasoned professionals, prioritizes accuracy and quality in every piece of content. With years of experience in journalism and publishing, we work diligently to deliver reliable and well-researched content to our readers.

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Discussion Comments

By anon1000506 — On Oct 05, 2018

I had asthma as a child, but was told by a doctor that I had a barrel chest. When I was 30 years old, another doctor told me I wasn't barrel chested, just well developed (I'm a female). Even if I do have a barrel chest, I don't think it looks bad!

By anon976268 — On Oct 31, 2014

I've got the barrel chest. I was told in childhood that I had COPD and would have emphysema "someday." That turned out to be the ripe old age of 36.

Everybody, including doctors seeing me for the first time, say that I shouldn't smoke/should quit. I never started.

By nnitschke — On Aug 06, 2012

My son, who is only 6, has had a bad cough, and was poorly. At hospital they noticed he has a barrel chest (which he didn't have before). Is this something that he will grow out of? He hasn't had any long term medical problems.

By orangey03 — On May 11, 2012

My grandfather lived with emphysema for many years, and his chest expanded a lot as the disease progressed. It was so strange to see a man who didn't work out and didn't eat a whole lot develop such a wide ribcage area.

His lungs wheezed when he breathed, and even when he was resting in his chair, I could hear the rattling in his lungs. He never seemed to fully exhale, and it sounded as if he were slowly suffocating.

His chest didn't seem to move a lot as he breathed, either. I guess this was because it had already expanded so much.

By lighth0se33 — On May 10, 2012

My little brother suffers from terrible asthma, and he has a barrel chest. It is so sad to me that someone so young has a torso that resembles a wooden barrel.

He has so much trouble breathing, but he has a sweet disposition and a strong will to survive. His asthma problems have altered his appearance even with his shirt on, because he holds his shoulders abnormally high. He does this so that he can breathe better.

Thankfully, most of the kids at his school are sweet to him. I think that if they teased him about his barrel chest, it would make his asthma even worse to bear.

By seag47 — On May 09, 2012

@StarJo – Yes, I would think that those would be two different types of barrel chests. I have seen both, and I agree that no one would want to go for the elderly version.

My grandfather has a barrel chest that resembles an old oak barrel in our yard. The bottom half of it is gone, so it just starts out skinny at the top and ends up wide at the bottom. The elderly barrel chest usually widens out to the base of the ribs and goes straight down from there.

The physically fit kind of barrel chest is more like a full barrel. It narrows back down to a slim waist after expanding outward in a center of muscles.

By StarJo — On May 09, 2012

I had no idea that people actually tried to achieve the barrel chest look. I had always thought it was an unattractive thing, because I associated it with old men whose chests had expanded with age.

I have seen old men with little chicken legs and wiry arms who have barrel chests. Some of them have COPD, but others are just really old. Many of the elderly men in my family have this type of chest, and it does not seem like a thing to strive for.

Surely the bodybuilders achieve a different type of barrel chest than this. If it was layered over and held in place with strong muscles, then it would have to be more attractive.

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