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What Is Pneumothorax?

Pneumothorax is the medical term for a collapsed lung. Pneumothorax occurs when air enters the space around your lungs. Air can find its way into the pleural space when there’s an open injury in your chest wall or a tear or rupture in your lung tissue, which is disrupting the pressure that keeps your lungs inflated. Causes of ruptured or injured chest or lung walls can include lung disease, injury from a sport or accident, assisted breathing with a ventilator, or perhaps changes in air pressure that you experience when scuba diving or mountain climbing. Sometimes the cause of a pneumothorax is unknown. The change in pressure caused by an opening in your chest or lung wall can cause the lung to collapse and put pressure on the heart. The condition ranges in severity. If there’s only a small amount of air trapped in the pleural space, as can be the case in a spontaneous pneumothorax, it can often heal on its own if there have been no further complications.

Causes

A pneumothorax can be caused by:

  • Chest injury. Any blunt injury to your chest can cause lung collapse. Some injuries may happen during physical assaults or car crashes, while others may inadvertently occur during some medical procedures that involve the insertion of a needle into the chest.
  • Lung disease. Damaged lung tissue is more likely to collapse. Lung damage can be caused by many types of underlying diseases, including chronic obstructive pulmonary disease (COPD), cystic fibrosis and pneumonia.
  • Mechanical ventilation. A severe type of pneumothorax can occur in people who need mechanical assistance to breathe. The ventilator can create an imbalance of air pressure within the chest. The lung may collapse completely.

Symptoms

The symptoms of pneumothorax can vary from mild to life-threatening and may include:

  • shortness of breath
  • chest pain, which may be more severe on one side of the chest
  • sharp pain when inhaling
  • pressure in the chest that gets worse over time
  • increased heart rate
  • rapid breathing
  • confusion
  • loss of consciousness or coma

Some cases of pneumothoraces have almost no symptoms. These can only be diagnosed with an X-ray or another type of scan. Others require emergency medical attention. Anyone experiencing the symptoms should definitely contact their doctor or seek immediate medical help.

Diagnosing pneumothorax

Diagnosis is based on the presence of air in the space around the lungs. A stethoscope may pick up changes in lungs sounds, but detecting a small pneumothorax can sometimes be very difficult. Some imaging tests may be hard to interpret due to the air’s position between the chest wall and lung.

Imaging tests commonly used to diagnose pneumothorax include:

Treatment

The standard medical treatment usually involves inserting a small tube between the ribs or under the collarbone in order to release the gas that has built up. This will slowly decompress the lung. Doctors may prescribe various drugs to numb the pain, help remove toxins, or prevent infection. Some people may need oxygen if their lung capacity is deficient. Surgical treatment may be necessary in some cases, especially in individuals who have had repeated pneumothoraces. People with SSP are more likely to need medical attention due to the serious nature of the lung diseases associated with the condition. Those with SSP may experience more severe symptoms and face a greater risk of serious complications and death. Some very small pneumothoraces may heal without any treatment.

Your long-term outlook depends on the size of the pneumothorax, as well as the cause and treatment required. In general, a small pneumothorax that doesn’t cause significant symptoms can resolve with observation or minimal treatment. When a pneumothorax is large, results from trauma, affects both lungs, or is due to an underlying lung disease, treatment and recovery may be more complicated.