Doctor's Notes on Collapsed Lung (Pneumothorax) Symptoms, Causes, Types, Treatments, Surgery, and Outcome
A pneumothorax refers to the collection of air in the chest cavity surrounding the lung that causes the lung to collapse. A pneumothorax may occur on its own (known as a spontaneous pneumothorax) in the absence of underlying disease. It may also occur as a result of trauma or injury or due to the presence of an underlying lung disease. If the lung continues to leak air into the chest cavity and results in compression of the chest structures, this is referred to as a tension pneumothorax and must be treated immediately because it may compress the vessels that return blood to the heart.
Signs and symptoms of pneumothorax include sudden onset of a sharp chest pain that may cause a feeling of tightness in the chest. Associated signs and symptoms can include shortness of breath, rapid heart rate, rapid breathing, fatigue, and cough. If the lungs are not able to provide enough oxygen to the bloodstream, a bluish discoloration of the skin (cyanosis) may be present.
Collapsed Lung (Pneumothorax) Symptoms, Causes, Types, Treatments, Surgery, and Outcome Symptoms
- A collapsed lung feels like a sharp, stabbing chest pain that worsens on breathing or with deep inspiration. This is referred to as "pleuritic" because it comes from irritation of nerve endings in the pleura (inner lining of the rib wall). Interestingly, the lung tissue itself does not contain pain-sensing nerve endings.
- Pain often radiates to the shoulder and or back.
- A dry, hacking cough may occur because of irritation of the diaphragm.
- If a tension pneumothorax is present, signs of cardiovascular collapse and shock will occur. This is immediately life threatening.
- The large veins in the neck may stick out, or the skin may be a bluish color because of lack of oxygen (called cyanosis). The pulse may be rapid and the blood pressure decreased. The person appears quite anxious and may have difficulty speaking. If untreated for more than several minutes, loss of consciousness, shock, and death occur.
Collapsed Lung (Pneumothorax) Symptoms, Causes, Types, Treatments, Surgery, and Outcome Causes
The primary cause of a pneumothorax is trauma to the chest cavity. A fractured rib, for example, could puncture the lung. Moreover, penetrating trauma from a bullet, knife, or other sharp object can directly puncture the lung.
Who is at risk for pneumothorax?
- Sometimes, very tall, thin people are prone to a spontaneous pneumothorax. In this condition, the lung collapses after minimal or no trauma.
- Other risk factors are cigarette smoking and recreational drug use or abuse.
- This refers to a condition in which the lung collapses with no apparent injury or trauma.
- Abnormal, small, air-filled sacs in the lung called "blebs" typically rupture and leak air into the pleural space, leading to the spontaneous pneumothorax. This happens in the cases of tall and thin people, who because of the shape of their lungs and chest cavity, are seemingly more prone to these defects.
- Shortness of breath and sharp, stabbing chest pain develops in apparently healthy people.
- Cigarette smokers are at greater risk for spontaneous pneumothorax.
- Recreational drug users who inhale deeply and forcefully are also at greater risk.
- Direct trauma to the chest wall from either blunt or penetrating trauma causes this condition.
- Trauma also can come from diagnostic or therapeutic medical procedures that can result in a punctured lung such as needle aspiration of fluid from the pleural space, a lung biopsy, or insertion of a large IV catheter into a vein near the neck.
Disease-related pneumothorax can occur due to abnormalities in the lung tissue.
Costochondritis is an inflammation of the area where the ribs join the cartilage that is attached to the sternum. Costochondritis causes chest pain, especially upon palpation of the area. It is a benign condition that often resolves on its own without treatment. Chest pain from costochondritis must be differentiated from that of more serious conditions including heart attack, pericarditis, and other conditions. Costochondritis is a common cause of chest pain in children and adolescents.
COPD (Chronic Obstructive Pulmonary Disease) QuizQuestion
COPD (chronic obstructive pulmonary disease) is the same as adult-onset asthma.See Answer
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.