What are the signs of a collapsed lung. How is pneumothorax diagnosed. What treatments are available for a collapsed lung. Who is at risk for developing pneumothorax. Can a collapsed lung heal on its own.

Understanding Pneumothorax: A Comprehensive Overview

Pneumothorax, commonly known as a collapsed lung, is a serious medical condition that occurs when air escapes from the lung and fills the space between the lung and chest wall. This buildup of air puts pressure on the lung, preventing it from expanding fully during inhalation. Understanding the symptoms, causes, and treatment options for pneumothorax is crucial for early detection and proper management.

Recognizing the Symptoms of a Collapsed Lung

Identifying the signs of pneumothorax is essential for seeking timely medical attention. The symptoms can vary depending on the severity of the collapse:

• Sharp chest or shoulder pain, exacerbated by deep breathing or coughing
• Shortness of breath
• Nasal flaring (due to respiratory distress)
• Bluish skin color (cyanosis) in severe cases
• Chest tightness
• Lightheadedness or near-fainting episodes
• Easy fatigue
• Abnormal breathing patterns
• Rapid heart rate
• In extreme cases, shock and collapse

How quickly do symptoms of pneumothorax appear? Symptoms of a collapsed lung typically develop suddenly and can worsen rapidly, especially in cases of a large pneumothorax.

Common Causes and Risk Factors for Pneumothorax

Understanding the causes and risk factors associated with pneumothorax can help in prevention and early intervention. Collapsed lungs can occur due to various reasons:

Traumatic Causes:

• Chest injuries (e.g., gunshot or knife wounds)
• Rib fractures
• Certain medical procedures

Spontaneous Causes:

• Air blisters (blebs) on the lung surface rupturing
• Sudden changes in air pressure (e.g., scuba diving, high-altitude travel)

Risk Factors:

• Tall, thin body type
• Smoking
• Underlying lung diseases (asthma, COPD, cystic fibrosis, tuberculosis)
• Previous episodes of pneumothorax

Can pneumothorax occur without any apparent cause? Yes, in some cases, a collapsed lung can happen spontaneously without any identifiable trigger. This is known as spontaneous pneumothorax.

Diagnostic Procedures for Collapsed Lung

Accurate diagnosis of pneumothorax is crucial for appropriate treatment. Healthcare providers employ various methods to confirm the condition:

1. Physical examination: Listening to breath sounds with a stethoscope
2. Chest X-ray: The primary imaging tool for detecting pneumothorax
3. CT scan: Used when other injuries or conditions are suspected
4. Arterial blood gas analysis: To assess oxygenation levels
5. Electrocardiogram (ECG): To rule out cardiac causes of symptoms

How accurate is a chest X-ray in diagnosing pneumothorax? Chest X-rays are highly effective in detecting pneumothorax, with a sensitivity of about 80-90% for moderate to large collapses. However, small pneumothoraces may be missed, necessitating additional imaging in some cases.

Treatment Options for Pneumothorax

The treatment approach for a collapsed lung depends on the severity and underlying cause of the condition. Options include:

Conservative Management:

• Observation and oxygen therapy for small pneumothoraces
• Rest and pain management

Invasive Procedures:

• Needle aspiration: To remove air from around the lung
• Chest tube insertion: For larger pneumothoraces, to drain air and allow lung re-expansion
• Pleurodesis: Chemical scarring to prevent recurrence
• Lung surgery: To repair the area of air leak or prevent future episodes

How long does it take for a collapsed lung to heal? The recovery time for pneumothorax varies depending on its severity and the treatment method. Small pneumothoraces may resolve within a few days, while larger ones requiring chest tube placement may take 1-2 weeks to heal completely.

Preventing Recurrence and Long-term Management

After experiencing a pneumothorax, preventing future episodes is crucial. Strategies include:

• Smoking cessation
• Avoiding activities with sudden pressure changes (e.g., scuba diving)
• Regular follow-up with healthcare providers
• Managing underlying lung conditions

What is the likelihood of pneumothorax recurring? The recurrence rate for spontaneous pneumothorax ranges from 20-50% within the first 1-2 years, emphasizing the importance of preventive measures and follow-up care.

Complications and When to Seek Medical Attention

While many cases of pneumothorax resolve with proper treatment, complications can occur. These may include:

• Tension pneumothorax: A life-threatening condition requiring immediate intervention
• Recurring pneumothorax
• Prolonged air leak
• Infection

When should you seek emergency care for suspected pneumothorax? Seek immediate medical attention if you experience sudden chest pain, difficulty breathing, or worsening symptoms, especially if you have risk factors or a history of lung problems.

Living with Pneumothorax: Lifestyle Adjustments and Support

Adapting to life after experiencing a collapsed lung may require some lifestyle changes:

• Avoiding strenuous activities during recovery
• Gradual return to normal activities under medical guidance
• Joining support groups for individuals with lung conditions
• Regular medical check-ups and lung function tests

How can you improve lung health after pneumothorax? Engaging in breathing exercises, maintaining a healthy diet, staying physically active within recommended limits, and avoiding smoking can all contribute to better lung health and reduced risk of recurrence.

Understanding pneumothorax, its symptoms, causes, and treatment options is crucial for anyone at risk or those who have experienced this condition. By recognizing the signs early and seeking prompt medical attention, individuals can improve their outcomes and reduce the risk of complications. Remember, while a collapsed lung can be a frightening experience, with proper care and management, most people recover fully and can return to their normal activities.

Collapsed lung (pneumothorax): MedlinePlus Medical Encyclopedia

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A collapsed lung occurs when air escapes from the lung. The air then fills the space outside of the lung between the lung and chest wall. This buildup of air puts pressure on the lung, so it cannot expand as much as it normally does when you take a breath.

The medical name of this condition is pneumothorax.

Collapsed lung can be caused by an injury to the lung. Injuries can include a gunshot or knife wound to the chest, rib fracture, or certain medical procedures.

In some cases, a collapsed lung is caused by air blisters of the lung (blebs) that break open, sending air into the space around the lung. This can result from air pressure changes such as when scuba diving or traveling to a high altitude.

Tall, thin people and smokers are more at risk for a collapsed lung.

Lung diseases can also increase the chance of getting a collapsed lung. These include:

• Asthma
• Chronic obstructive pulmonary disease (COPD)
• Cystic fibrosis
• Tuberculosis
• Whooping cough

In some cases, a collapsed lung occurs without any cause. This is called a spontaneous collapsed lung or spontaneous pneumothorax.

Common symptoms of a collapsed lung include:

• Sharp chest or shoulder pain, made worse by a deep breath or a cough
• Shortness of breath
• Nasal flaring (from shortness of breath)

A larger pneumothorax causes more severe symptoms, including:

• Bluish color of the skin due to lack of oxygen
• Chest tightness
• Lightheadedness and near fainting
• Easy fatigue
• Abnormal breathing patterns or increased effort of breathing
• Rapid heart rate
• Shock and collapse

The health care provider will listen to your breathing with a stethoscope. If you have a collapsed lung, there are decreased breath sounds or no breath sounds on the affected side. You may also have low blood pressure.

Tests that may be ordered include:

• Chest x-ray
• Arterial blood gases and other blood tests
• CT scan if other injuries or conditions are suspected
• Electrocardiogram (ECG)

A small pneumothorax may go away on its own over time. You may only need oxygen treatment and rest.

The provider may use a needle to allow the air to escape from around the lung so it can expand more fully. You may be allowed to go home if you live near the hospital.

If you have a large pneumothorax, a chest tube will be placed between the ribs into the space around the lungs to help drain the air and allow the lung to re-expand. The chest tube may be left in place for several days and you may need to stay in the hospital. If a small chest tube or flutter valve is used, you may be able to go home. You will need to return to the hospital to have the tube or valve removed.

Some people with a collapsed lung need extra oxygen.

Lung surgery may be needed to treat collapsed lung or to prevent future episodes. The area where the leak occurred may be repaired. Sometimes, a special chemical is placed into the area of the collapsed lung. This chemical causes a scar to form. This procedure is called pleurodesis.

If you have a spontaneous collapsed lung, you are more likely to have another one in the future if you:

• 
  Are tall and thin
• 
  Continue to smoke
• 
  Have had two collapsed lung episodes in the past

How well you do after having a collapsed lung depends on what caused it.

Complications may include any of the following:

• Another collapsed lung in the future
• Shock, if there are serious injuries or infection, severe inflammation, or fluid in the lung develops

Contact your provider if you have symptoms of a collapsed lung, especially if you have had one before.

There is no known way to prevent a collapsed lung. Following standard procedure can reduce the risk of a pneumothorax when scuba diving. You can decrease your risk by not smoking.

Air around the lung; Air outside the lung; Pneumothorax dropped lung; Spontaneous pneumothorax

• Lungs
• Aortic rupture – chest x-ray
• Pneumothorax – chest x-ray
• Respiratory system
• Chest tube insertion – series
• Pneumothorax – series

Hallifax R, Rahman NM. Pneumothorax. In: Broaddus VC, Ernst JD, King TE, et al, eds. Murray and Nadel’s Textbook of Respiratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 110.

Peak DA. Scuba diving and dysbarism. In: Walls RM, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 131.

Raja AS. Thoracic trauma. In: Walls RM, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 37.

Updated by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Know the Signs of a Collapsed Lung

You may have heard of a collapsed lung, but what exactly does that mean, and how do you treat it? 

A collapsed lung, or pneumothorax, happens when air escapes from your lung and fills the space between the lung and chest wall. The lung is then not able to expand normally when you take a breath. The condition is rare but could be life-threatening, so you should seek immediate care.

Symptoms of a collapsed lung include:

• Dull, steady ache in the chest
• Pain upon inhaling
• Shortness of breath
• Chest tightness
• The sensation that you can’t draw breath
• Face turning blue due to lack of oxygen
• Very fast heartbeat

What Causes a Collapsed Lung?

Impact with Blunt Object. This is the leading cause of a collapsed lung. It can happen when playing sports where you might collide with a ball or person. A car crash can also involve an impact to the chest wherein this injury could occur.

Puncture. Any penetrating wound to the chest can puncture the lung. This could be something violent, like a knife or stab wound. It could also be the result of vigorous play, such as a pencil stabbing. An aerosol can exploding could also cause a collapsed lung.

Disease. Diseases such as emphysema and COPD can lead to a collapsed lung. Certain infections, such as pneumonia, can be the culprit, too.

Spontaneous pneumothorax. Very tall and typically very thin male young adults are especially prone. For these people, the pneumothorax can just occur; you don’t need to be hit in the chest or have other trauma for it to happen.    

Hospital procedures. In the hospital, some medical procedures, such as the insertion of a chemotherapy port to your chest, can also sometimes damage your lung.

What To Do Immediately After Injury

The most pressing concern is to make sure oxygen is flowing. Emergency services should be called immediately, and you will be administered oxygen as you are transported to a hospital.

When oxygen escapes from the lungs, they can’t function fully and properly. Supplying oxygen keeps the lungs working and helps replace some of the missing air. Psychologically, the sooner your breathing returns to a more normalized state, the sooner your body receives the signal to relax. Supplied oxygen can help the pneumothorax get smaller too. 

How a Collapsed Lung Is Treated

Treatment is determined by how much of the lung is collapsed. If just a small portion is affected, your doctor may admit you to the hospital for observation. If you have a tiny wound, it can easily seal over.

If the affected area is larger, your doctor will evacuate the air that has escaped from the lung and is gathering in the chest cavity. Each time air gets pushed out from the lung, it is then trapped and pushing against the lung. Picture your lung as a balloon, and in this case, it’s pushed against a wall. This misplaced air can also exert pressure on the heart, which is another reason to address the problem quickly.

Your doctor will explore all nonsurgical options. One of the first steps is to place a small chest tube with a suction device to evacuate the air from outside the lung.

A second course of treatment might be a patch through which your own blood can be inserted to seal the injury. Alternatively, another substance may be inserted through the chest tube to intentionally irritate the lung lining, causing it to stick together and seal up.

If the affected lung area doesn’t seal with these measures, your doctor can perform a video-assisted surgery to find where the air is escaping and repair it.

Your doctor will make the most conservative treatment choice possible, escalating only when necessary.

What To Do After Treatment

After the wound has been treated, it’s important that, for the next two to four weeks, you avoid:

• Flying on airplanes
• Scuba diving
• Playing a wind instrument
• Playing contact sports or participating in anything where a chest hit might occur

Once the injury has fully healed, you’re safe to resume these activities and your normal lifestyle.

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Pneumothorax – causes, symptoms of the disease, diagnosis and treatment of the disease

Spontaneous pneumothorax is one of the most dangerous and severe injuries. 10% are faced with it, and one in ten of those who have experienced lung collapse dies within the first day after the onset of the disease. We understand, due to the presence of air in the pleural cavity, and what needs to be done for those who are faced with this injury.

How does a collapsed lung occur?

The lungs are paired organs located in the chest. Between them and the ribs that limit the chest, there is a cavity called the pleural cavity. This cavity is lined with a pleura – a special serous membrane that protects the respiratory organs from external influences.

The pleural cavity is sealed. Normally, there is no air inside it, but there is negative pressure. Because of this, the lungs are straightened and can function normally. But sometimes the tightness of the pleural cavity is broken. Most often this occurs with injuries, certain diseases or operations on the chest.

Pneumothorax is a violation of the integrity of the pleural membrane of the lungs. As a result, the lungs are deformed and cannot perform their function. Often this process occurs spontaneously for no apparent reason.

When this phenomenon does not have an obvious cause, they speak of the development of spontaneous pneumothorax. With it, the integrity of the pleura is violated, air enters it. Due to depressurization, the lungs are compressed, their deformation occurs and their function is impaired. This manifests itself in the form of respiratory failure, pain in the chest. This condition is called a collapsed lung.

Pathology should be distinguished from a violation of the integrity of the main respiratory organ, when it is easily burst or pierced. This also leads to air entering the pleural cavity. This pathology usually develops due to injuries and illnesses and does not apply to spontaneous pneumothorax, so the tactics of treating this pathology should be different.

Several harmful factors can influence the development of a collapsed lung. These usually include:

• Consequences of diseases of the lungs, in which adhesions form in them.
• The lung diseases themselves, which lead to changes in the lung tissue.
• Smoking, including electronic cigarettes, which causes damage to the lung tissue.
• Excessive physical activity, which can provoke pleural tear and lung injury.
• A genetic predisposition that manifests itself in diseases such as Marfan’s syndrome and some others.
• Sudden pressure drops that occur when flying in an airplane, diving to great depths, or playing wind instruments.

Most often, pneumothorax occurs in thin middle-aged adult men. It rarely develops in women and children. This disease is recurrent: after the first attack, relapse occurs in 25% of cases. Moreover, the likelihood of a relapse increases with each new episode of the disease. Spontaneous pneumothorax develops both on the right and on the left.

Main types of pneumothorax

Pneumothorax is distinguished by the cause of its occurrence, the side of the lesion, the severity of the course, and some other signs. It is necessary to determine the causes of the pathology in order to properly carry out therapeutic and resuscitation measures.

Open pneumothorax develops against the background of external injuries of the chest and the appearance of holes in it. If a hole is formed in the lung, then a closed type of lung collapse develops. Depending on the lesion, right-sided, left-sided or bilateral pneumothorax is distinguished.

The disease can occur with or without complications, develop primarily as an independent disease, or itself be a consequence of other diseases. It may occur for the first time or be recurrent.

According to the severity of the course and localization of damage, there are:

By origin, they distinguish:

• traumatic pneumothorax;
• artificial pneumothorax;
• post-traumatic pneumothorax;
• valvular pneumothorax;
• limited pneumothorax;
• infectious pneumothorax.

These species are distinguished by the reason that led to its appearance. Traumatic and post-traumatic form develops due to direct trauma. Infectious include, for example, spontaneous pneumothorax in tuberculosis or pneumonia. To the valve – one that occurs due to a violation of the proper circulation of air in the lung.

Pay attention! Pain in the chest area can be a sign of a variety of pathologies, which include such serious illnesses as a heart attack. Therefore, if pain occurs, you should immediately consult a doctor or call an ambulance.

Main symptoms and signs

The main symptom of pneumothorax is a sharp pain in the chest area, which can radiate to the shoulder area. The intensity of the pain syndrome is individual and depends on other factors (state of health, mobility of the nervous system, etc.). Some simply note discomfort and a feeling of bloating in the chest.

The more air accumulates in the pleural cavity, the more pronounced the symptoms of lung damage. In addition to pain, cough, shortness of breath, pallor of the skin, tachycardia, rapid breathing, causeless lacrimation, dizziness appear.

These symptoms arise due to the fact that the lung collapses, it cannot perform its function completely and oxygen starvation develops. All organs suffer from it, but primarily the brain. The longer this condition lasts, the more serious the consequences.

Pneumothorax pain is often confused with other diseases, such as osteochondrosis, and the “wrong” disease is treated. Improper treatment leads to the fact that the patient develops complications that can lead to complete loss of the lung. Our doctors at a remote consultation will carefully study your medical history and help to exclude negative diagnoses

Complications of pneumothorax

The lungs are the first to suffer from pneumothorax. Their long bonding leads to adhesions, the development of a persistent inflammatory process (chronic pneumonia, obstructive pulmonary disease, and so on). If left untreated, abscesses can develop in the lung tissue, which can threaten complete removal of the lung.

If the air goes beyond the redistribution of the pleural cavity and enters other organs, emphysema develops in them. Most often, this complication occurs in the area of ​​​​the skin, heart and large vessels. In the latter case, this leads to their compression and can cause death.

Also, against the background of pneumothorax, respiratory failure often develops. Lack of oxygen affects all organs – from the brain to small vessels. The longer the organs do not receive a normal amount of oxygen, the more serious their damage.

In addition to air, fluid can accumulate in the pleural cavity. This leads to the development of hydropneumothorax, pleurisy and replacement of healthy connective tissues. This process is not reversible and significantly impairs the quality of human life. In addition, untimely treatment leads to constant recurrences of pneumothorax.

Diagnosis of disease

Diagnosis is based on clinical symptoms, medical history, and examination. The doctor will definitely case the breath. With pneumothorax, it occurs auscultatively, that is, wheezing and noises in the chest are clearly audible in it. On external examination, the expansion of the intercostal space and the chest itself is noticeable.

To confirm and clarify the diagnosis, an x-ray of the lungs is prescribed. An x-ray image assesses the degree of collapse of the lung (the degree of its collapse) and the structure of changes in them, as well as some of the reasons due to which air entered the chest.

For more accurate diagnosis, other methods can be used – ultrasound and multislice computed tomography. Additionally, continuous monitoring of saturation is recommended to determine the degree of oxygen starvation.

Case study:

The man went to the ambulance with acute pain in the heart. He also complained that he could not take a deep breath. Initial examination revealed pallor of the skin, rapid breathing and tachycardia.

The patient was referred for an x-ray to rule out trauma, as well as an ultrasound of the heart to rule out a heart attack. The picture showed signs of collapse of the lungs on the background of chronic obstructive disease.

The patient was released from the pleural cavity, prescribed a treatment that helps to expand the lung and left under observation in the hospital.

Methods of treatment of pneumothorax

Treatment of pneumothorax is aimed at eliminating air from the pleural cavity, restoring lung function and preventing the development of complications, as well as preventing recurrence of the disease. In the treatment of lung collapse, conservative and surgical tactics are used.

Drug treatment is prescribed for minor stages of lung damage and no signs of respiratory failure. At the same time, analgesics are prescribed to reduce pain, as well as prophylactic doses of antibiotics to prevent the development of inflammation.

To remove excess air from the pleural cavity and restore lung function, a puncture is prescribed. The puncture is carried out on between 2 and 3, as well as 4 and 5 ribs. The needle is inserted under local anesthesia, so patients usually tolerate the procedure well.

With a severe course of the disease, multiple complications and the inability to do without surgical intervention, an operation is performed. A bronchoblocker is placed in the lungs, which prevents the lung from collapsing. Also, complete or partial amputation of the damaged organ is carried out.

If pneumothorax has developed as a complication of another disease or has been caused by injuries, excessive physical activity, or other conditions, these causes should be corrected.

If a pneumothorax is suspected, do not self-medicate and perform a puncture on your own. Without a certain experience, it is easy to damage the lung. Our doctors will remotely help you determine the cause of pain and, if necessary, call an ambulance.

Prevention of lung collapse

The prognosis in the treatment of the disease is usually favorable. If the patient complies with all the doctor’s prescriptions and leads a healthy lifestyle, a complete recovery occurs, and repeated attacks are rare.

To prevent primary pneumothorax, it is recommended to exclude the factors provoking it:

• timely diagnosis and treatment of pulmonary diseases;
• completely stop smoking;
• dose physical activity;
• try to avoid chest injuries;
• eat normally and avoid strict diets;
• compliance with the rules when flying and immersing in water.

Helps in the prevention of pneumothorax breathing exercises. It develops the lungs and prevents their injury. Also, such exercises help to avoid hypoxia during the attack itself.

FAQ

Why is pneumothorax dangerous?

+

With pneumothorax, the integrity of the chest is broken and air enters it. Because of this, the lungs collapse, respiratory failure and other complications develop.

What treatment is recommended for hydropneumothorax?

+

In the treatment of this disease, both conservative and surgical methods are used. Treatment is prescribed by a doctor based on the clinical picture and the severity of the course of the disease.

Who is most likely to develop pneumothorax?

+

Most often, thin adult men suffer from pneumothorax. What this is connected with is not known for certain. In second place are women. Pneumothorax is rare in children.

Can pneumothorax be treated at home?

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No, treatment must be carried out under the supervision of a doctor in a hospital setting. With the rapid development of respiratory failure, the patient may require oxygen and urgent resuscitation.

What causes chronic pneumothorax?

+

There is no such thing as chronic pneumothorax. In clinical practice, they speak of a recurrent form of lung collapse. It occurs as a complication of spontaneous pneumothorax.

Expert opinion

Pneumothorax is a disease that can threaten the patient’s life. If it occurs, you need to see a doctor as soon as possible and restore lung function. After that, the patient needs frequent dispensary observation, since this pathology is often recurrent.

Spontaneous pneumothorax – treatment abroad

Spontaneous pneumothorax – treatment abroad

• What is this?

• Causes and risk factors

• What are the symptoms of the disease?

• How is it diagnosed?

• How is it treated?

• Where do we treat it?

Causes and risk factors

Primary pneumothorax is caused by the spontaneous rupture of small bubbles, usually located in the apex of the lungs, which may be caused by the habit of smoking. Secondary pneumothorax is caused by lung diseases, in particular emphysema. Primary pneumothorax is typical for men who are young (from 15 to 24 years old), tall and slender. In women of childbearing age, pneumothorax may occur at the same time as the menstrual cycle (menstrual pneumothorax). Secondary penumothorax is characteristic of the elderly and directly correlates with pathologies that develop with age.

What are the symptoms of the disease?

The patient may complain of difficulty in breathing and stabbing pains in the chest. An irritating cough may be present.

How is it diagnosed?

Chest x-ray detects air in the pleural space. Chest CT may show vesicles on the surface of the lungs and/or the presence of pleuropulmonary lesions.

Recommended Diagnostics

How is it treated?

If the lung collapse is less than 20%, the patient is in good general condition and with mild symptoms, the pneumothorax may resolve spontaneously and the patient is only observed.