Pneumothorax

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Overview

A pneumothorax is defined as a collection of air outside the lung but within the pleural cavity. It occurs when air accumulates between the parietal and visceral pleurae inside the chest. The air accumulation can apply pressure on the lung and make it collapse. The degree of collapse determines the clinical presentation of pneumothorax. Air can enter the pleural space by two mechanisms, either by trauma causing a communication through the chest wall or from the lung by rupture of visceral pleura. There are two types of pneumothorax: traumatic and atraumatic. The two subtypes of atraumatic pneumothorax are primary and secondary. A primary spontaneous pneumothorax (PSP) occurs automatically without a known eliciting event, while a secondary spontaneous pneumothorax (SSP) occurs subsequent to an underlying pulmonary disease. A traumatic pneumothorax can be the result of blunt or penetrating trauma. Pneumothoraces can be even further classified as simple, tension, or open. A simple pneumothorax does not shift the mediastinal structures, as does a tension pneumothorax. Open pneumothorax is an open wound in the chest wall through which air moves in and out.

Symptoms

A collapsed lung can have many signs and symptoms. If you have symptoms of a collapsed lung, go to the emergency room. You may need immediate care.


Signs of a collapsed lung include:


Chest pain on one side especially when taking breaths.

Cough.

Fast breathing.

Fast heart rate.

Fatigue.

Shortness of breath.

Skin that appears blue.

Causes

Pneumothorax has three main causes: medical conditions, injuries and lifestyle factors.


Medical conditions that may cause a collapsed lung include:


Asthma.

Pneumonia.

Chronic obstructive pulmonary disease (COPD).

Collagen vascular disease.

Cystic fibrosis.

Emphysema.

Endometriosis in the chest.

Idiopathic pulmonary fibrosis.

Lung cancer.

Lymphangioleiomyomatosis.

Marfan syndrome.

Tuberculosis.

Acute respiratory distress syndrome (ARDS), a condition caused by pneumonia, coronavirus and other illnesses.

Injuries that may cause collapsed lung are:


Blunt force trauma.

Certain types of ventilation or changes to ventilation.

Gunshot wound.

Lung puncture during a medical procedure, like a biopsy or nerve block.

Stab wound.

Lifestyle factors associated with collapsed lung are:


Drug use, especially inhaled drugs.

Flying that involves drastic changes in air pressure.

Scuba or deep-sea diving.

Smoking.

People with certain other risk factors may be more likely to have a collapsed lung. These are:


Family history of pneumothorax.

Pregnancy.

Tall, thin body type.

Risk factors

The risk factorsTrusted Source are different for a traumatic and spontaneous pneumothorax.

Risk factors for a traumatic pneumothorax include:

contact sports, like football or hockey

employment where there’s a risk of falls or other types of injury

having a medical procedure that involves the chest or lung area

ongoing assisted respiratory care

The people at highest risk of a nontraumatic pneumothorax include those who:

have a history of smoking

have an existing lung condition, like asthma or COPD

have a family history of pneumothorax, which may indicate genetic factors

have tall, slim bodies, as this can affectTrusted Source pressure at the top of the lung

have inflammation in the small airways


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Complications

The complications of pneumothorax include effusion, hemorrhage, empyema; respiratory failure, pneumomediastinum, arrhythmias and instable hemodynamics need to be handled accordingly. Treatment complications refer to major pain, subcutaneous emphysema, bleeding and infection, rare re-expansion pulmonary edema.

Prevention

If you have certain medical conditions or a family history of pneumothorax, you might not be able to prevent a collapsed lung.


Anyone can take steps to reduce your chances of collapsed lung:


Stop smoking.

Avoid or limit activities with drastic changes in air pressure (scuba diving and flying). Follow your provider’s recommendations if you do these activities.

See your provider regularly to monitor any lung conditions.