Atelectasis vs Pneumothorax: What’s the Difference?
What Is Atelectasis?
Atelectasis is a complete or partial collapse of the lung or lobe of a lung. This medical condition develops when the tiny sacs, known as alveoli, present within the lung become deflated.
This is a breathing complication which often occurs after surgery. Apart from surgery, it is also a possible complication of cystic fibrosis, inhaling foreign objects, tumors pertaining the lung, fluid fill up in the lungs, or any type of chest injury.
This medical condition can lead to breathing difficulties and lower levels of oxygen, especially if there is the presence of lung disease in the patient already. The treatment of this condition again depends on the cause and the severity of the issue.
What Is Pneumothorax?
Collapsing of the lungs can lead to pneumothorax wherein there is leakage of air in the space between the lungs and wall of the chest. This air which is leaking pushes on the outside of the lungs; thus, leading to collapse. However, in most cases, only a portion of the lung collapses. Pneumothorax is often caused by a chest injury, lung damage caused by various conditions, or certain types of medical procedures.
The symptoms of pneumothorax often include pain in the chest or shortness of breath. In certain cases, the collapsing of the lung can also become life-threatening. The treatment of this condition usually involves the identification of the underlying cause.
The Difference Between Atelectasis and Pneumothorax
Here, we will explore the differences between these two conditions.
Definition
A collapsed lung occurs when air enters the pleural space, the location between the chest wall and the lung. If it is a complete collapse, it is known as pneumothorax. However, if only a portion of the lung is affected, it is known as atelectasis.
Causes
Lung collapse (atelectasis) is commonly caused by a blockage of the air passage, which blocks the supply of oxygen to the blood stream. Pressure that occurs outside of the lung could be the cause of this collapse. Pleural effusions, tumors, mucus, and other tiny particles could block the air passage; thus, causing atelectasis.
Pneumothorax can be triggered by lung disease, thoracic trauma, rupture of cysts, esophagus perforation, or other pleural infections. If an individual breaks a rib or is stabbed in the lung, it could result in a release of air into the chest; thus, pneumothorax occurs. In those who suffer from TB, asthma, emphysema, chronic bronchitis, cystic fibrosis, and pertussis, pneumothorax occurs spontaneously. Those who smoke are also at greater risk of having pneumothorax.
Signs and Symptoms
The symptoms of atelectasis include:
- Chest pain
- Persistent cough
- Breathing difficulties
- Irregular heartbeat
- Increase in respiratory rate.
The symptoms of pneumothorax include:
- Dry cough
- Sudden feeling of breathlessness
- Sudden chest pain that worsens when air is inhaled.
In some cases, there is entry of air in the pleural cavity but the air does not pass or escape from this pleural cavity, which is often caused due to tension in pneumothorax. Such conditions must be treated urgently and a doctor should be contacted immediately. Additionally, patients can experience changes in skin color which would appear as a bluish discoloration.
Risk Factors
Factors that increase the risk of developing atelectasis include:
- Anesthesia
- Foreign objects present in the airway
- Use of a breathing tube
- Lung diseases
- Shallow breathing
- Mucus that blocks the airway
- Extended bedrest with little change in position
- Pressure on the lung due to a buildup of fluid between the lung and ribs (known as pleural effusion).
The risk factors for pneumothorax vary depending on the cause of the condition. Some of the factors that increase the risk of pneumothorax include:
- Gender – Men are more likely to develop pneumothorax than women.
- Smoking – The risk of pneumothorax can increase depending on how long the individual smoked and in what quantity.
- Age – Pneumothorax that is caused by ruptured air blisters often occurs in people 20-40 years of age. This is especially the case for individuals who are underweight or very tall.
- Genetics – Certain forms of pneumothorax tend to run in families.
- Lung disease – Suffering from an underlying lung disease, especially COPD, makes the collapse of a lung more likely.
- Mechanical ventilation – Individuals who require mechanical ventilation to help them breath are at a greater risk of pneumothorax.
- Previous pneumothorax – Individuals who have previously suffered a pneumothorax are at greater risk of suffering another, often within 1-2 years following the first.
Diagnosis
An X-ray and CT scan of the chest area is the best method for properly diagnosing either of the previously mentioned conditions. In atelectasis, there is a shift of the windpipe or trachea to the affected side. However, in pneumothorax, the trachea shifts to the opposite side. An oximetry test can also be carried out for diagnosing atelectasis. For this simple test, a small device is placed on one of the fingers. Once this device is in place, it will measure the saturation of oxygen in the blood.
Treatment
For atelectasis, the doctor will advise the patient to perform chest physiotherapy, which can be done in the form of deep breathing exercises. If there is blockage in the passage, then they may advise that a bronchoscopy be carried out. To perform a bronchoscopy procedure, a thin, flexible tube is inserted via the nose into the airways. This is done so as to clear the airway. If there is a tumor present, which is also one of the causes of atelectasis, the doctor will go in for the surgical method. The removal of the tumor can be done by carrying out radiotherapy or chemotherapy. Certain medications such as antibiotics would also be prescribed by the doctor to treat any cases of infection. Bronchodilators are used to reduce sputum.
When it comes to pneumothorax, the goal of treatment is to relieve the pressure on the lung, allowing it to re-expand. In cases where the larger area of the lung has collapsed, it is likely that a chest tube or needle will be used to help remove the excess air. If the chest tube fails to work, surgery may be needed to close the air leak. If the cause of the issue is an infection, then antibiotics can be given to help.
Complications
The complications of atelectasis include:
- Acute pneumonia
- Hypoxemia and respiratory failure
- Bronchiectasis
- Post-obstructive drowning of the lung
- Sepsis
- Pleural effusion and empyema
The complications of pneumothorax include:
- Recurrence within 1-2 years following the first pneumothorax
- Respiratory failure
- Circulatory failure
- Shock
When to See a Doctor
Seek medical attention immediately if you begin to have trouble breathing. There are other conditions besides atelectasis that can lead to breathing difficulties and require diagnosis and prompt treatment. Therefore, if you find that you are having issues breathing, it is important to seek medical assistance.
