Barrel Chest: Causes, Symptoms, Diagnosis, and Treatment Options
Lung & RespiratoryCOPD

What Is Barrel Chest?

What Is Barrel Chest?
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Published on August 5, 2024
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Barrel chest occurs when your lungs become hyperinflated with air, forcing the rib cage to expand for longer and work harder.

Although experts don’t know exactly how many people experience barrel chest, the Centers for Disease Control and Prevention estimates that over 14 million Americans have COPD, the most common cause of hyperinflated lungs.

What Does Barrel Chest Look Like?

“Barrel chest is a visible symptom of lung conditions that cause the lungs to overfill with air, pushing out the ribs, chest, and upper back bones,” says Raj Dasgupta, MD, pulmonologist, critical care physician, and sleep medicine specialist at Keck Medicine of USC (University of Southern California) and chief medical advisor for the National Council on Aging.

Typically, your chest depth is about half the size of your chest width, but with barrel chest, your upper torso can become equally wide and deep.

Causes of Barrel Chest

Barrel chest can be caused by a number of conditions, including:

Chronic Obstructive Pulmonary Disease (COPD)

Both types of COPD, which largely includes emphysema and chronic bronchitis, can lead to a barrel-shaped chest, Dr. Dasgupta says. “With COPD, the air sacs in your lungs get damaged, making it harder to exhale and causing air to get trapped in your lungs. This trapped air then bulges out your chest, giving it that barrel-like look,” explains Dasgupta.

Asthma

When you have asthma, your airway (the path from your mouth to your lungs) narrows and swells, sometimes producing extra mucus, which can make it hard to breathe.

 Asthma can sometimes make your lungs hyperinflate, much like with COPD, which may lead to a barrel-shaped chest, especially at the time of an attack.

Cystic Fibrosis

A genetic condition, cystic fibrosis causes thickened mucus to form in your lungs, pancreas, and other organs in the body. As this mucus builds up, it can trap air and make it harder to breathe.

Skeletal Deformities Such as Kyphosis or Scoliosis

The human spine is naturally curved, but for some, it can be severely curved or bend in the wrong direction.

 Kyphosis, for example, involves excess rounding of the upper back, and scoliosis causes the spine to curve sideways in an S-shape.

 These bone abnormalities can lead to barrel chest if they block full lung expansion, says Dasgupta.

Barrel Chest Diagnosis

To diagnose barrel chest, your doctor will discuss your medical history and give you a physical exam, focusing on your chest shape and how your lungs sound. They may prescribe imaging tests like chest X-rays and CT scans or pulmonary function tests.

These tests determine how much air you can inhale and exhale both at rest and with activity. Your provider may prescribe one or two of these common tests:

  • Spirometry Measures your inhale, exhale, and lung capacity
  • Body plethysmography Measures your lung capacity and how much air stays in your lungs after exhale
  • Gas diffusion study Measures how much oxygen gets into your blood from your lungs
  • Cardiopulmonary exercise test Measures your heart, lung, and muscle function during exercise

Since barrel chest can occur from a number of different conditions, your physician may also want to test for the most common culprits. Many of these conditions also use the lung function tests above, but they can include more in-depth diagnostic measures. 

Barrel Chest Treatment Options

Most treatment options for barrel chest involve addressing the underlying condition and making some lifestyle changes, says Dasgupta.

Treat Underlying Respiratory Conditions

While no treatment can completely eliminate your risk for barrel chest, better-controlled COPD can lower your risk. You can ask your healthcare provider about your specific treatment plan.

Medication Management Be sure to take any prescribed medications like bronchodilators and inhaled corticosteroids to improve your breathing, Dasgupta says.

Pulmonary Rehabilitation Programs Pulmonary rehabilitation programs can offer exercises and education to help improve your lung function and quality of life.

Oxygen Therapy for Hypoxemia If your oxygen levels dip below a certain level too often, your provider may add oxygen therapy to your treatment, which can keep your levels up, says Dasgupta.

Lifestyle Modifications “Lifestyle changes, like quitting smoking and maintaining a healthy weight, are also very important," says Dasgupta. You can also use breathing techniques and provider-approved exercise to address your underlying lung issues.

Practice Proactive Prevention

The earlier you can address any breathing issues, the better you can keep them under control.

 Your healthcare provider can offer support and guidance as you manage a chronic illness.

If you begin to feel symptoms, be sure to let your healthcare provider know right away. That way, you can give your lungs a chance at easy breathing. And because barrel chest happens with air trapping, the more you can keep your breathing optimal, the better chance you have at avoiding a barrel chest.

The Takeaway

A barrel chest looks like a bulging and rounded upper torso, and can happen in anyone with a chronic condition that causes lung overinflation. The best way to treat barrel chest is by treating the underlying condition and proactive prevention with medication management, pulmonary rehabilitation, and lifestyle changes.

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Michael S. Niederman, MD

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