Symptoms and Signs of Chest Injuries

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 10/12/2021

Doctor's Notes on Chest Injuries

A chest injury or trauma is any injury to the ribs, heart, or lungs and can occur as the result of an accidental or deliberate penetration of a foreign object into the chest. This type of injury can also result from a blunt trauma, leading to chest wall injury, which causes rib bruises, fracture, lung, or heart contusions.

Symptoms of chest injury may include

  • difficulty breathing,
  • failure of the chest to expand normally,
  • crunching sounds in the ribs,
  • bruising,
  • coughing up blood, or
  • one segment of the chest wall may not move with breathing or move opposite to the rest of the chest wall (flail chest).

A person with a chest injury should seek medical treatment as soon as possible because even without an obvious external injury, a significant internal injury can occur.

What Is the Treatment for Chest Injuries?

With the exception of minor chest injuries (contusions or bruises), most chest injuries require medical evaluation and treatment. Treatment for specific chest injuries depends on the severity and the mechanism of the injury. 

Some common chest injuries and their treatment include:

  • Rib fractures
    • Single isolated, non-displaced rib fractures only require symptomatic care with pain medications and rest
    • Multiple rib fractures that are displaced or causing flail chest may require surgery
  • Air in the chest cavity from a punctured or damaged lung (pneumothorax)
    • Placement of a chest tube to relieve or prevent built up pressure in lung cavity
    • A small pneumothorax may not require a chest tube
  • Penetrating injury to the chest wall (such as a stab or a gunshot wound)
    • These injuries are treated surgically and can cause the most damage internally
  • Chest contusion from blunt trauma
    • Testing of the heart, lungs, and chest wall for internal damage or bleeding
    • If severe, admission to the hospital for monitoring and a possible need for surgery

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.