Barrel chest generally refers to a broad, deep chest found on a man. A man described as barrel chested will usually have a naturally large ribcage, very round (i.e., vertically cylindrical) torso, large lung capacity, and can potentially have great upper body strength. It can sometimes be a sign of acromegaly (a syndrome resulting from excess levels of human growth hormone (HGH) in the body). It is most commonly related to osteoarthritis as individuals age. Arthritis can stiffen the chest causing the ribs to become fixed in their most expanded position, giving the appearance of a barrel chest.
Barrel chest also refers to an increase in the anterior posterior diameter of the chest wall resembling the shape of a barrel, most often associated with emphysema. There are two main causes of the barrel chest phenomenon in emphysema:
- Increased compliance of the lungs leads to the accumulation of air pockets inside the thoracic cavity.
- Increased compliance of the lungs increases the intrathoracic pressure. This increase in pressure allows the chest wall to naturally expand outward.
Barrel chest occurs naturally in native people who live at altitudes of over 5500 m, e.g. the Himalayas or the Andes. These natives also have polycythemia and other accommodations for high altitude life. 
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