It is caused by increased pulmonary blood flow.
The increased pulmonary blood flow is defined as a pre-requisite for the induction of advanced vascular lesions in pulmonary arterial hypertension in congenital heart disease.
The barrel chest is most often associated with emphysema. When the too much air get trapped into lungs it gives some patients a barrel-chested appearance.
The emphysema is a lung disease which causes destruction of the fragile walls and elastic fibers of the alveoli. Small airways collapse when people exhale.
The internal intercostal muscles are also important in altering the anteroposterior dimension of the chest cavity. It consists of 11 pairs. APD is defined as the distance from anterior skin to the posterior skin.
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It's important to be honest and straight forward with doctors so the they have all the information to make a correct diagnosis.
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I believe that is TRUE. I apologize if that is wrong, but i hope I helped!