Pneumothorax: Symptoms of a Collapsed Lung

Pneumothorax is the medical term for a collapsed lung. A more accurate translation of pneumothorax would be air (pneumo) in the chest (thorax). A collapsed lung occurs when air leaks into the space between the chest wall and the pleura (the membrane sacs that contain the lungs).

Chest trauma and chest injury are the most common causes of pneumothorax. Approximately nine out of every 100,000 people develop pneumothorax every year in the United States.

Causes of Pneumothorax

A collapsed lung occurs when air in the chest cavity interferes with a lung's air pressure. While chest trauma and injury are the most common causes of pneumothorax, a number of other causes exist. Pneumothorax cases are categorized as one of four types, depending on underlying causes and symptom severity:

• Primary spontaneous pneumothorax affects otherwise healthy people with no history of chest trauma or chest injury and occurs when a small lung blister, or bleb, ruptures. The ruptured bleb allows air to leak from the lung into the chest cavity. Primary spontaneous pneumothorax symptoms are usually mild, as the amount of air that escapes into the chest is limited. High-risk candidates of primary spontaneous pneumothorax are tall, thin male smokers between the ages of 20 and 40. This variety of pneumothorax can run in families.
  
  
• Secondary spontaneous pneumothorax occurs in people suffering from progressive lung disease. Emphysema, pneumonia, tuberculosis, lung cancer and cystic fibrosis are all potential causes of pneumothorax. Secondary spontaneous pneumothorax symptoms develop when damaged lung tissue lies next to the pleura. Secondary spontaneous pneumothorax symptoms are more severe than primary spontaneous pneumothorax, as larger areas of lung are involved.
  
  
• Traumatic pneumothoraxis caused by chest trauma or chest injury. Chest trauma is a broad term covering such injuries as knife wounds, gunshot wounds, falls, car accidents and chest injury sustained while playing contact sports. Other causes of traumatic pneumothorax include:
  
  • breathing with the assistance of mechanical ventilators
  • chest injury due to CPR
  • chest surgery
  • heart surgery
  • liver biopsy
  • lung biopsy.
  Traumatic pneumothorax treatment is often complicated by the presence of hemothorax (bleeding into the chest cavity).
• Tension pneumothorax occurs when air pressure within the chest cavity exceeds atmospheric pressure. Air within the lungs compresses the lungs, heart and blood vessels. Tension pneumothorax symptoms and chest pain are severe. Without treatment, the condition is fatal. Complications of tension pneumothorax include respiratory failure, cardiac arrest, shock and hypoxemia (critically low levels of oxygen in the blood).

Pneumothorax Risk Factors

Risk factors for pneumothorax include the following:

• being a male
• existing lung disease
• personal or family history of pneumothorax
• smoking.

Chest Pain and Pneumothorax Symptoms

Chest pain and other pneumothorax symptoms vary in intensity depending on the extent of the collapsed lung. It is possible for a collapsed lung to affect the entire lung. More often, however, pneumothorax involves only a portion of the total lung.

Even a mild case of pneumothorax causes chest pain. Pneumothorax causes sudden, sharp chest pain that usually generally occurs on the same side of the body as the collapsed lung.

Other pneumothorax symptoms include:

• dry hacking cough
• feeling of tightness in the chest
• painful breathing
• shortness of breath
• tachycardia (rapid heart rate).

Tension pneumothorax symptoms can also include cyanosis (blue-tinged skin due to low blood oxygen levels), low blood pressure and engorged neck veins.

Treating a Collapsed Lung

Pneumothorax treatment depends on the severity of the collapsed lung. A mild case of pneumothorax may not require treatment at all. Up to 25 percent of a lung can collapse and, barring complications, can heal without treatment within one or two weeks. Such cases are carefully monitored if treatment is required.

If pneumothorax affects more than 25 percent of the lung, corrective treatment is required. A thin needle or chest tube is inserted into the chest cavity. A suction device is then attached to the tube and air is sucked out of the chest cavity. Depending on the amount of air in the chest cavity, treatment can last several hours or several days until the lung re-expands.

Resources

Mayo Foundation for Medical Education and Research. (April 3, 2007). Pneumothorax. Retrieved November 8, 2007, from the Mayo Web site: www.mayoclinic.com/health/pneumothorax/DS00943/DSECTION=1.

Aetna Intelihealth. (updated January 30, 2003). Pneumothorax. Retrieved November 8, 2007, from the Intelihealth Web site: www.intelihealth.com/IH/ihtIH/WSIHW000/9339/23665.html.