Pneumothorax: Symptoms & Treatment

Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

Pneumothorax can be almost nothing at all, or an extremely dangerous condition. Thus, it's important to recognize its signs and symptoms as well as potential treatment options.

Air in the Chest

Bob is short of breath. What could it possibly be? Maybe he just ran up a flight of stairs and is simply winded. Perhaps he has heart problems. Maybe he has asthma. Or, he may be just really emotional right now. All of these can leave Bob short of breath. But Bob may not know that the cause of his shortage of air, so to speak, is actually too much air in the chest.

Most of us rightfully think that air in the chest is a normal thing. We know that if we didn't have any air in our lungs as we breathed in, we'd die. So air in the chest is all good when it's in the lungs. But what you may not know is that air in the chest that gets outside of the lungs is a potentially deadly problem.

This is called pneumothorax, which means air in the pleural space, or the space between the lung and the inner chest wall. It's otherwise known as a collapsed lung. Let's find out what symptoms someone with this problem can expect, and what the treatment options for it are.

The arrow is pointing to the collapsed lung in a pneumothorax

Signs and Symptoms of Pneumothorax

The signs and symptoms of pneumothorax all depend on what the underlying problem is. Generally speaking, a person may experience any combination of the following:

  • A sudden dull, sharp, or stabbing type of chest pain
  • The chest pain becomes worse when the person coughs or breathes in deeply
  • Shortness of breath
  • Rapid yet shallow breathing
  • Cough

In more serious cases of pneumothorax, additional signs and symptoms may be present, including:

  • A blue discoloration in the skin as a result of an inadequate supply of oxygen
  • Fast heart rate and/or a weak pulse
  • Anxiety
  • Enlarged neck veins
  • Decreased breath sounds on the side of the collapse
  • Death (potentially) within minutes in the most serious types of pneumothorax, called tension pneumothorax

Pneumothorax Treatment

The end goal of any medical treatment of pneumothorax is straightforward: There is air in the pleural space. There should be no air here. Thus, we need to somehow get rid of this air.

Depending on how severe the pneumothorax is, treatment will vary. If a person has a very small pneumothorax, it may just resolve on its own and that's kind of it. This is appropriate for patients who show no clinical signs. In some cases of a small pneumothorax, supplemental oxygen is administered to ensure the patient is getting enough oxygen into their body. The administration of this oxygen also helps the small pneumothorax heal faster then it would if the patient were just breathing room air.

However, many patients require more in-depth medical attention than supplemental oxygen. If the pneumothorax is still relatively small, the patient may just need simple aspiration. In this process, a needle is attached to a syringe, then be inserted into the chest where it can suck the air out. If the pneumothorax is larger, then a chest tube with a one-way airflow valve will have to be placed through the chest wall. This will help the air escape out of the chest, but it won't allow the air to come back in. The affected lung will expand back to a normal size within a few days.

In cases where the pneumothorax comes back repeatedly, or there is an underlying lung disorder that's causing air to leak into the chest from the lungs, then surgery may be necessary to correct the defect that's causing the pneumothorax.

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