What is pneumothorax and how does it affect the lungs?
A pneumothorax, commonly known as a collapsed lung, is a condition that can develop suddenly and cause discomfort or difficulty breathing.
In this article, Dr Gary Davies, a consultant respiratory physician, explains what causes a pneumothorax, how it affects the lungs, the warning signs to watch for, and the treatment options available.
Understanding pneumothorax
The lungs are normally surrounded by a thin layer of fluid within the pleural space. This space allows the lungs to expand and contract smoothly with each breath. A pneumothorax occurs when air leaks into this space, disrupting the normal pressure that keeps the lungs inflated and causing the lung to collapse partially or completely. This reduces the lung’s capacity to take in oxygen and can cause shortness of breath.
Types of pneumothorax
- Spontaneous pneumothorax occurs without any apparent cause. Often seen in tall, thin individuals or in people with underlying lung conditions such as chronic obstructive pulmonary disease (COPD) or cystic fibrosis.
- Traumatic pneumothorax results from chest injuries such as falls, car accidents, or medical procedures like a lung biopsy or central line insertion.
- Tension pneumothorax is a life-threatening form in which air builds up under pressure in the chest, compressing the lung and other organs. This requires emergency treatment.
Recognising the symptoms
Common symptoms include sudden, sharp chest pain, often on one side, shortness of breath, rapid heart rate, and fatigue or a feeling of tightness in the chest. In severe cases, particularly tension pneumothorax, symptoms may also include low blood pressure, bluish lips or fingers, and fainting. Seek urgent medical attention immediately if these occur.
How pneumothorax is diagnosed
Doctors diagnose a pneumothorax through a combination of methods. During a physical examination, they may detect reduced or absent breath sounds on the affected side. Imaging tests, such as chest X-rays or CT scans, are commonly used to confirm the presence of air in the pleural space. In emergency settings, ultrasound is increasingly used for rapid detection, allowing doctors to make a prompt diagnosis.
Treatment options
Treatment depends on the size of the pneumothorax and the patient’s overall health. Small pneumothoraces may resolve on their own with monitoring and oxygen therapy. In other cases, needle aspiration or a chest drain may be used to remove air and allow the lung to re-expand. Surgery may be required for recurrent or persistent pneumothoraces, such as video-assisted thoracoscopic surgery (VATS), to prevent further collapses.
Most people recover fully with appropriate treatment, although follow-up scans may be recommended to ensure complete lung recovery.
A pneumothorax can develop suddenly and be distressing, but with prompt recognition and treatment, most people make a full recovery.
If you experience sudden chest pain or difficulty breathing, consult with Dr Davies via his Top Doctors profile.