Pneumothorax: Causes, Symptoms, Diagnosis, and Treatment

Breathing is one of the most natural actions we perform — until something goes wrong. One such medical emergency that can suddenly make breathing difficult is pneumothorax, commonly known as a collapsed lung.

Pneumothorax occurs when air leaks into the space between the lung and chest wall, causing the lung to collapse partially or completely. This condition can range from mild and self-resolving to severe and life-threatening.

Understanding pneumothorax, its causes, warning signs, and treatment options can help ensure timely medical intervention and prevent complications.

What Is Pneumothorax?

A pneumothorax refers to the presence of air in the pleural space — the thin cavity between the lungs and the chest wall. This air buildup increases pressure around the lungs, making it difficult for them to expand normally during breathing.

When this pressure increases significantly, it can cause the affected lung to collapse and, in severe cases, shift the heart and other structures — a critical condition known as a tension pneumothorax.

Types of Pneumothorax

Pneumothorax is classified based on its cause and severity:

1. Spontaneous Pneumothorax

This type occurs without any trauma or external injury.

• Primary Spontaneous Pneumothorax (PSP):
  Occurs in otherwise healthy individuals, typically tall, thin young men, often due to rupture of small air blisters (blebs) on the lung surface.

• Secondary Spontaneous Pneumothorax (SSP):
  Occurs in people with underlying lung diseases, such as:

  • Chronic Obstructive Pulmonary Disease (COPD)

  • Cystic fibrosis

  • Tuberculosis

  • Asthma

  • Interstitial lung disease

2. Traumatic Pneumothorax

Caused by chest injury that allows air to enter the pleural space. Common causes include:

• Road traffic accidents

• Penetrating chest wounds (stab or gunshot)

• Broken ribs puncturing the lung

• Medical procedures like lung biopsy, mechanical ventilation, or central line insertion

3. Tension Pneumothorax

This is a medical emergency. Air enters the pleural space but cannot escape, leading to rising pressure that collapses the lung and compresses the heart and major blood vessels. It requires immediate intervention to prevent cardiac arrest.

4. Catamenial Pneumothorax

A rare type linked with the menstrual cycle, often due to endometriosis affecting the diaphragm.

Causes and Risk Factors of Pneumothorax

Causes

Pneumothorax can develop due to:

• Ruptured air blisters (blebs or bullae)

• Chest injuries or trauma

• Invasive medical procedures

• Lung infections like tuberculosis or pneumonia

• Mechanical ventilation with high pressure

• Underlying lung disorders

• Sudden changes in air pressure (scuba diving, flying)

Risk Factors

Certain factors increase susceptibility:

• Smoking (even in small amounts)

• Chronic lung disease (COPD, cystic fibrosis)

• Tall and thin body type

• Family history of pneumothorax

• Previous pneumothorax episode

• Mechanical ventilation

• Genetic conditions such as Marfan syndrome

Symptoms of Pneumothorax

The symptoms depend on the extent of lung collapse and the underlying cause. Common symptoms include:

• Sudden, sharp chest pain

• Shortness of breath

• Rapid heart rate (tachycardia)

• Fatigue or dizziness

• Cyanosis (bluish discoloration of skin/lips)

• Tightness or pressure in the chest

• Rapid breathing

• Dry cough

• Decreased oxygen levels (low SpO₂)

In severe or tension pneumothorax:

• Severe respiratory distress

• Low blood pressure (hypotension)

• Distended neck veins

• Tracheal deviation (shift of windpipe)

If you experience these symptoms, seek emergency medical care immediately.

How Is Pneumothorax Diagnosed?

Timely diagnosis is critical for effective management. Diagnostic procedures may include:

1. Physical Examination

The doctor listens to your chest with a stethoscope for reduced or absent breath sounds on one side.

2. Chest X-ray

A simple and effective test that shows the presence of air in the pleural space and the extent of lung collapse.

3. CT Scan (Computed Tomography)

Provides a detailed image of the lungs, helping identify small pneumothoraces or underlying lung disease.

4. Ultrasound

Often used in emergency settings to detect pneumothorax quickly and guide needle decompression.

At Sparsh Diagnostic Centre, advanced imaging technologies ensure accurate and prompt diagnosis.

Treatment Options for Pneumothorax

Treatment depends on the size, cause, and severity of the pneumothorax.

1. Observation

For small, mild pneumothoraces without significant symptoms:

• The body may absorb the trapped air naturally.

• Doctors may recommend rest and repeat imaging to monitor progress.

2. Needle Aspiration

A needle and syringe are used to remove air from the pleural space, allowing the lung to re-expand.

3. Chest Tube Insertion (Thoracostomy)

For larger or more symptomatic pneumothorax:

• A chest tube is inserted between the ribs to continuously remove air until the lung re-expands.

4. Surgery (Pleurodesis or Pleurectomy)

If pneumothorax recurs or doesn’t resolve:

• Pleurodesis: A chemical or surgical method to adhere the lung to the chest wall and prevent recurrence.

• Video-Assisted Thoracoscopic Surgery (VATS): Minimally invasive surgery to remove blebs or repair the lung.

5. Emergency Treatment for Tension Pneumothorax

Immediate needle decompression followed by chest tube insertion is required to relieve pressure and restore breathing.

Possible Complications

Untreated or severe pneumothorax can lead to:

• Respiratory failure

• Recurrent lung collapse

• Shock and cardiac arrest (in tension pneumothorax)

• Infection (empyema)

• Lung scarring or decreased lung function

Prompt diagnosis and proper medical care significantly reduce these risks.

Prevention Tips

While not all cases are preventable, certain steps can reduce the risk:

• Quit smoking – Smoking weakens lung tissue and increases the risk of bleb rupture.

• Avoid sudden pressure changes – Refrain from diving or high-altitude travel if you have a recent pneumothorax history.

• Follow post-surgical care – If you’ve had chest surgery or lung disease, adhere strictly to medical advice.

• Regular lung check-ups – For those with chronic lung diseases or previous episodes, periodic imaging helps in early detection.

Living with Pneumothorax

Recovery from pneumothorax depends on its severity and treatment approach.

• Most patients recover fully within a few weeks.

• Avoid strenuous activities until your doctor confirms complete lung re-expansion.

• Follow-up X-rays are crucial to ensure no residual air remains.

• Patients who’ve experienced a pneumothorax should remain vigilant for recurring symptoms.

With proper diagnosis and care, most individuals lead normal, healthy lives after recovery.

When to Seek Medical Help

Seek immediate medical attention if you experience:

• Sudden chest pain or tightness

• Shortness of breath

• Rapid heartbeat

• Cyanosis (bluish lips or nails)

• Dizziness or fainting

Early intervention can be lifesaving.

Pneumothorax and Diagnostic Imaging at Sparsh Diagnostic Centre

At Sparsh Diagnostic Centre, we offer advanced diagnostic facilities for quick and accurate detection of pneumothorax and other lung conditions.
Our services include:

• Digital X-ray for immediate lung imaging

• High-Resolution CT (HRCT) Chest for detailed lung evaluation

• Ultrasound guidance for chest procedures

With expert radiologists and state-of-the-art technology, we ensure accurate diagnosis and timely reporting for better patient outcomes.

Pneumothorax is a serious condition that requires prompt diagnosis and treatment to prevent complications. Recognizing early symptoms, such as sudden chest pain or shortness of breath, and seeking immediate medical care can make a life-saving difference.

Whether it’s caused by trauma, underlying lung disease, or spontaneous rupture, modern diagnostic tools and medical interventions can effectively manage pneumothorax and prevent recurrence.

Visit Sparsh Diagnostic Centre for accurate diagnosis, expert guidance, and compassionate care for all your respiratory health needs.

Frequently Asked Questions (FAQ)

1. What causes pneumothorax?

Pneumothorax occurs when air leaks into the pleural space due to trauma, lung disease, or ruptured air blisters. It can also occur spontaneously in healthy individuals.

2. Can pneumothorax heal on its own?

Small pneumothoraces often heal naturally as the body absorbs the air. However, larger ones require medical intervention.

3. Is pneumothorax life-threatening?

Yes, severe cases — especially tension pneumothorax — can be life-threatening and need immediate emergency treatment.

4. How is pneumothorax diagnosed?

It’s typically diagnosed using a chest X-ray, CT scan, or ultrasound, depending on the case and available facilities.

5. Can pneumothorax recur?

Yes, recurrence is possible, especially in patients with underlying lung diseases or smokers.

6. How long does recovery take?

Recovery usually takes 2 to 6 weeks, depending on the size and cause of the pneumothorax.

7. Can you prevent pneumothorax?

Avoiding smoking, following medical advice after lung procedures, and avoiding high-pressure activities like scuba diving can help reduce the risk.

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