Pneumothorax – Symptoms and Causes
Overview
A pneumothorax is a medical condition where air enters the space between the lung and chest wall, causing the lung to collapse partially or completely. This condition creates pressure against the lung, preventing it from expanding properly during breathing.
The collapse can affect a small section of the lung or the entire organ.
Several factors can trigger a pneumothorax. These include:
- Chest injuries (both blunt and penetrating)
- Certain medical procedures
- Underlying lung diseases
- Spontaneous occurrence with no clear cause
Most patients experience two primary symptoms: sudden chest pain and difficulty breathing. These symptoms typically appear without warning and may vary in severity.
In severe cases, a pneumothorax can become life-threatening and requires immediate medical attention. Treatment generally involves removing the trapped air using a needle or chest tube inserted between the ribs.
Small pneumothorax cases may sometimes heal without medical intervention, though they still require careful monitoring by healthcare professionals.
Signs and Symptoms
The most common symptoms of a collapsed lung include sharp chest pain that comes on suddenly and trouble breathing. How bad these symptoms feel may vary based on how much of the lung has collapsed.
When Medical Help Is Needed
If you notice chest pain or breathing problems, get medical help right away. These symptoms might point to serious health issues that need treatment. For severe chest pain or if breathing gets harder, go to the emergency room immediately.
Causes
Pneumothorax (collapsed lung) can happen for several reasons.
Physical Trauma to the Chest
- Blunt force injuries during accidents or assaults
- Car collisions
- Accidental damage during medical procedures with needles
Underlying Lung Conditions
Certain diseases make the lung tissue weaker and more prone to collapse:
- COPD
- Cystic fibrosis
- Lung cancer
- Pneumonia
- Cystic lung diseases like lymphangioleiomyomatosis and Birt-Hogg-Dube syndrome
Air Blister Rupture
Small air-filled sacs (blebs) sometimes form on the upper parts of the lungs. When these burst, air leaks into the space around the lungs, causing collapse.
Ventilator Complications
People on breathing machines face special risks. The pressure from mechanical ventilation can create an uneven air distribution in the chest. This pressure imbalance may lead to a complete lung collapse, which is a serious medical emergency.
Risk Factors
Men face a much higher chance of developing pneumothorax compared to women. People between ages 20 and 40 are most vulnerable to the type caused by ruptured air blisters, with tall, thin individuals at particular risk.
Having lung disease or being on a ventilator increases your risk. Smoking significantly raises the danger, with risk growing based on how long and how much you’ve smoked, even without emphysema.
Genetics play a role, as certain types of pneumothorax tend to run in families. This suggests a possible inherited tendency for this condition.
If you’ve had a pneumothorax before, you’re at higher risk of experiencing another one. This recurrence risk is why doctors often recommend preventive measures after the first episode.
Complications
Complications from pneumothorax depend on several factors, including size, severity, cause, and treatment approach.
The most common complications include:
- Ongoing air leakage when the lung opening fails to close properly
- Recurrence of pneumothorax after initial treatment
- Tension pneumothorax (a medical emergency where pressure builds in the chest)
- Respiratory distress causing breathing difficulty
Some patients may experience persistent symptoms even after treatment. The risk of recurrence is particularly high for certain individuals, especially those with underlying lung diseases or previous episodes.
Treatment-related complications can also occur. For example, chest tube insertion might lead to infection, bleeding, or pain at the insertion site. Surgical interventions carry their own risks, including infection and extended recovery time.
Long-term management may be necessary for patients with recurrent pneumothorax. This might include lifestyle modifications such as avoiding activities that increase pressure in the chest cavity (scuba diving, air travel, or high-altitude climbing).
For patients with persistent air leaks, newer treatments such as endobronchial one-way valves might be considered. These devices help seal the leaking area without requiring major surgery.
