The term "barrel chest" describes a

rounded, bulging chest that

resembles the shape of a barrel.
Barrel chest isn't a disease, but it
may indicate an underlying
condition.
Barrel chest most commonly relates
to osteoarthritis as you age. Arthritis
can stiffen the joints where the ribs
attach to the spine, not unlike what
happens to aging finger joints. The
ribs become fixed in their most
expanded position, causing the
appearance of a barrel chest.
Some people who have chronic
obstructive pulmonary disease
such as emphysema develop a
slight barrel chest in the later stages
of the disease. It occurs because the
lungs are chronically overinflated
with air, so the rib cage stays
partially expanded all the time. This
makes breathing less efficient and
aggravates shortness of breath.
Generally, barrel chest itself isn't
treated, but when the cause is
severe emphysema, the underlying
disease is treated
Emfisema
What is emphysema?
Emphysema is a condition that
involves damage to the walls of the
air sacs (alveoli) of the lung.
Normally there are more than 300
million alveoli in the lung. The alveoli
are normally stretchy and springy,
like little balloons. Like a balloon, it
takes effort to blow up normal
alveoli; however, it takes no energy
to empty the extra effort needed to
breathe results in a person feeling
short of breath. Airway obstruction
occurs in emphysema because the
alveoli that normally support the
airways open cannot do, so during
inhalation or exhalation. Without
their support, the breathing tubes

collapse, causing obstruction to the

flow of air.
Symptom
You can have emphysema for many
years without noticing any signs or
symptoms. The main symptom of
emphysema is shortness of breath,
which usually begins gradually. You
may start avoiding activities that
cause you to be short of breath, so
the symptom doesn't become a
problem until it starts interfering with
daily tasks. Emphysema eventually
causes shortness of breath even
while you're at rest.
See your doctor if you've had
shortness of breath for several
months, especially if it's getting
worse or it's interfering with your
daily activities. Don't try to attribute
it to your deconditioning or age or
weight. Seek immediate medical
attention if:

You're so short of breath, you

can't talk

Your lips or fingernails turn

blue or gray

You're not mentally alert

Your heartbeat is very fast

Complication
People who have emphysema are
also more likely to develop:

Collapsed lung
(pneumothorax). A collapsed lung
can be life-threatening in people
who have severe emphysema,
because the function of their
lungs is already so compromised.

Heart problems. Emphysema

can increase the pressure in the
arteries that connect the heart
and lungs. This can cause a
condition called cor pulmonale, in
which a section of the heart
expands and weakens.

Large holes in the lungs (giant

bullae). Some people with
emphysema develop empty
spaces in the lungs called bullae.
Giant bullae can be as large as
half the lung. In addition to
reducing the amount of space
available for the lung to expand,
giant bullae can become infected
and are more prone to causing a
collapsed lung (pneumothorax).

The main cause of emphysema is

long-term exposure to airborne
irritants, including:
-Tobacco smoke
-Marijuana smoke
-Air pollution
-Manufacturing fumes
-Coal and silica dust

Occupational exposure to
fumes or dust. If you breathe
fumes from certain chemicals or
dust from grain, cotton, wood or
mining products, you're more
likely to develop emphysema.
This risk is even greater if you
smoke.

Exposure to indoor and

outdoor pollution. Breathing
indoor pollutants, such as fumes
from heating fuel, as well as
outdoor pollutants car exhaust,
for instance increases your risk
of emphysema.

Medications

Smoking cessation
drugs. Prescription medications,
such as bupropion hydrochloride
(Zyban) and varenicline (Chantix),
can help you quit smoking.

Bronchodilators. These
drugs can help relieve coughing,
shortness of breath and trouble
breathing by relaxing constricted
airways, but they're not as
effective in treating emphysema
as they are in treating asthma or
chronic bronchitis.

Inhaled
steroids. Corticosteroid drugs
inhaled as aerosol sprays may
help relieve shortness of breath.
But prolonged use can weaken
your bones and increase your risk
of high blood pressure, cataracts
and diabetes.

Antibiotics. If you develop a

bacterial infection, like acute
bronchitis or pneumonia,
antibiotics are appropriate.

Factors that increase your risk of

developing emphysema include:

Smoking. Emphysema is
most likely to develop in cigarette
smokers, but cigar and pipe
smokers also are susceptible. The
risk for all types of smokers
increases with the number of
years and amount of tobacco
smoked.

Age. Although the lung

damage that occurs in
emphysema develops gradually,
most people with tobacco-related
emphysema begin to experience
symptoms of the disease between
the ages of 40 and 60.

Exposure to secondhand
smoke. Secondhand smoke, also
known as passive or
environmental tobacco smoke, is
smoke that you inadvertently
inhale from someone else's
cigarette, pipe or cigar. Being
around secondhand smoke
increases your risk of
emphysema.

Therapy

Pulmonary rehabilitation. A
pulmonary rehabilitation program
can teach you breathing exercises
and techniques that may help
reduce your breathlessness and
improve your ability to exercise.
You'll also receive advice about
proper nutrition. In the early
stages of emphysema, many
people need to lose weight, while

people with late-stage

emphysema often need to gain
weight.

Supplemental oxygen. If
you have severe emphysema with
low blood oxygen levels, using
oxygen regularly at home and
when you exercise may provide
some relief. Many people use
oxygen 24 hours a day. It's
usually administered via narrow
tubing that fits into your nostrils.

Surgery
Depending on the severity of your
emphysema, your doctor may

suggest one or more different types

of surgery, including:

Lung volume reduction. In

this procedure, surgeons remove
small wedges of damaged lung
tissue. Removing the diseased
tissue helps the remaining lung
tissue work more efficiently and
helps improve breathing.

Lung transplant. Lung

transplantation is an option if you
have severe emphysema and
other options have failed.