Pneumothorax
Also known as: Collapsed Lung
What is it?
Pneumothorax is commonly called collapsed lung. Each lung is covered by a membrane, called the pleura, that folds back to make a lining for the chest cavity. If air collects in the pleural space between the rib cage and a lung, the air causes part or all of the lung to collapse. Pneumothorax can occur for no apparent reason, called a spontaneous pneumothorax, or can be caused by injury. The most serious type is a tension pneumothorax, where the chest cavity fills with air and the extreme pressure causes the lung to collapse completely.
Who gets it?
Men who are tall, thin, and under the age of 40 are more likely to experience a simple spontaneous pneumothorax. A complicated spontaneous pneumothorax is more likely to occur in people with lung disease, such as emphysema, or lung conditions like asthma, cystic fibrosis, chronic bronchitis, tuberculosis, and certain types of pneumonia. Adults and infants who have severe acute respiratory distress syndrome and need the help of a mechanical ventilator to breathe are also more likely to develop pneumothorax. The high pressure oxygen pumped in by the ventilator can damage the lungs. People who suffer a serious chest injury in a motor vehicle accident or violent crime, undergo certain medical procedures that allow air into the chest cavity, or are middle-aged and have had long-term asthma, chronic bronchitis, or emphysema are more likely to have a tension
pneumothorax.
What causes it?
Under normal conditions, the pressure in the pleural space, the area around the lungs, is lower than the pressure inside the lungs. However, if air is able to enter the pleural space, the pressure outside the lungs becomes too great, causing part or all of a lung to collapse. A spontaneous pneumothorax can be caused when a small weakened area of the lungs, called a bulla, breaks open (ruptures). Or, it can be caused by pressure changes in the lungs caused by scuba diving or flying at high altitudes. Spontaneous pneumothorax may also be caused when lungs are weakened by lung disease. Tension pneumothorax occurs when the lung collapses completely and presses on the heart. The collapsed lung pushes the heart and its blood vessels to the other side of the chest, and the heart cannot pump normally.
What are the symptoms?
Pneumothrax symptoms vary according to how much air enters the chest, whether the lung is partially or completely collapsed, and any lung disease or condition that complicates the condition. With a simple or complicated spontaneous pneumothorax, the patient will experience shortness of breath and chest pain that ranges from dull to sharp. The patient may have a dry cough, breathe rapidly, and have little chest movement with each breath. Symptoms usually occur suddenly, and are more severe in people with a pre-existing lung condition. Taking deep breaths or coughing makes symptoms worse. With mild pneumothorax, the symptoms begin to go away as the lung slowly begins to reinflate on its own. With a tension pneumothorax, symptoms occur very suddenly and are very severe. The patient becomes extremely anxious, has a weak pulse, and decreased breath sounds on the side of the lung collapse. The most obvious outward sign is enlarged neck veins. The trachea, or windpipe, may also be pushed to one side.
How is it diagnosed?
To diagnose a pneumothorax, a doctor will check for normal breathing sounds by listening to the patient’s chest with a stethoscope. He or she will also order a chest x-ray, which will show any air pocket in the chest cavity and the condition of the lung. If tension pneumothorax is suspected, an electrocardiogram
(ECG) lets the doctor see the rate and rhythm of the heart. A test called an arterial blood gas is also used to check a blood sample for oxygen and carbon dioxide levels.
What is the treatment?
Treatment depends upon the cause and size of the
pneumothorax. A small pneumothorax may not require any treatment because the air is absorbed within a few days and the lung returns to normal. However, most cases of pneumothorax require hospitalization. With a smaller
pneumothorax, a needle and syringe can be used to suction the air out of the chest cavity. When the pneumothorax is large and the patient is having difficulty breathing, a chest tube is inserted through the chest wall. The tube is connected to a valve that lets the air escape from the chest cavity, but doesn’t let any air back in. Once the air is removed, the lung can re-expand. A tension pnuemothorax is a life-threatening condition. Air is quickly removed using a needle and syringe, then a chest tube is inserted to continue suctioning the air. With any treatment, the medical staff constantly monitors the patient’s breathing and heart rates, and blood oxygen levels. People who experience recurring
pneumothorax, such as those who frequently dive or fly at high altitudes, may need surgery to seal the pleural space so air cannot collect there. People with lung disease may also have recurring
pneumothorax, but may not be good candidates for surgery because of possible complications. These patients may be given
doxycycline, an antibiotic drug, through a chest tube to seal the pleural space.
Self-care tips
You can help prevent spontaneous pneumothorax by keeping your lungs healthy. Don’t smoke, and follow your doctor’s recommendations for treatment of any respiratory problems. If you have a
pneumothorax, keep your head elevated with pillows and take acetaminophen or ibuprofen, with your doctor’s approval, to lower any pain. Get plenty of rest and try not to cough. When traveling in a motor vehicle, always wear a seatbelt to help avoid serious chest injury in an accident.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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