What are the main signs of pneumothorax?

Written by Hao Ze Rui
Pulmonology
Updated on August 31, 2024
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If it is a small amount of pneumothorax, the physical signs are generally not obvious, especially when patients with emphysema develop pneumothorax, it is difficult to detect any signs. However, when a larger amount of pneumothorax occurs, inspection will reveal that the affected side of the chest is bulging and respiratory movements are reduced. Upon palpation, the trachea usually shifts towards the healthy side, tactile fremitus on the affected side is reduced, percussion results in hyperresonance or tympany, and auscultation shows reduced breath sounds, which can disappear in severe cases.

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Written by Li Tao
Pulmonology
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What are the symptoms of pneumothorax?

Pneumothorax refers to the accumulation of air that occurs when air enters the pleural cavity, a closed space, which is known as pneumothorax. The most common clinical manifestations of pneumothorax depend on the speed of onset, the degree of lung compression, and the etiology of the primary disease causing the pneumothorax. Typically, patients may experience a high level of mental tension, fear, restlessness, shortness of breath, and a feeling of suffocation. Some individuals may sweat, have an increased pulse rate, with the most prominent symptom being difficulty in breathing. Additionally, some patients may experience coughing and chest pain, and some may develop mediastinal emphysema, leading to gradually worsening respiratory difficulties, and even manifestations of shock such as a drop in blood pressure.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Causes of pneumothorax

The causes of pneumothorax vary with age. In young people, the condition often occurs in tall, thin individuals, somewhat akin to a balloon. We can liken the lung to a balloon: for shorter, heavier individuals, the balloon is rounder and experiences more uniform stress, whereas for tall, thin individuals, it's as if the balloon is being stretched vertically. Therefore, the tips of the balloon (or the lung) in tall, thin individuals are more prone to rupture. Additionally, for tall, thin individuals, the blood supply to the apical alveoli may not be as robust, making them more susceptible to micro-ruptures. Microscopic anatomical structures have also proven that there are tiny pores in the apical bubble tissues in these individuals. In older adults, the causes of pneumothorax are usually underlying lung diseases, such as chronic smoking, chronic obstructive pulmonary disease (COPD), chronic bronchitis, and other conditions like tuberculosis or HIV infections can also lead to pneumothorax. Some cases are due to traumatic causes like physical injuries or stab wounds, which can lead to secondary or iatrogenic pneumothorax. In summary, while the causes of pneumothorax vary by age, in young people, it more commonly stems from being tall and thin. In older individuals, smoking, tobacco use, chronic bronchitis, and infections are more common causes.

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Written by Han Shun Li
Pulmonology
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Are the symptoms of pneumothorax severe?

Pneumothorax is caused by a rupture of the pleura, allowing air to enter the pleural cavity. The severity of symptoms after suffering from pneumothorax can vary, with common symptoms including coughing, chest pain, chest tightness, and difficulty breathing. The severity of symptoms largely depends on the amount of air in the pleural space. If the amount of air is small, symptoms might not be noticeable. However, with a larger amount of air, difficulty breathing can be quite severe. In cases of tension pneumothorax, the symptoms can be extremely severe and may even lead to respiratory and circulatory failure in a short period. Patients often experience significant chest tightness, restlessness, dry skin, heavy sweating, and may even lose consciousness. Immediate treatment is necessary, as there could be a risk to life.

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Written by Wang Xiang Yu
Pulmonology
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Pneumothorax, which department should it go to?

Which department is better for pneumothorax treatment? There isn't a strict definition dictating which specific department one must visit for pneumothorax. Generally, you can visit the respiratory department or the cardiothoracic surgery department. If the patient's condition is very severe, then the first choice should be the emergency department, where emergency treatment can be provided before further referral.

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Can pneumothorax recover by itself?

Pneumothorax is caused by a rupture of the pleura, allowing air to enter the pleural space. Patients often display symptoms such as coughing, chest pain, chest tightness, and shortness of breath. A lung radiograph can confirm the presence of a pneumothorax. Whether a patient with pneumothorax can recover on their own depends on the size of the pneumothorax. If it is a large pneumothorax, especially a communicative or tension pneumothorax, self-recovery is not possible, and treatment generally involves pleural puncture or pleural drainage tube placement. However, if the amount of air in the pneumothorax is small and the patient does not exhibit severe symptoms, then it is possible for the condition to resolve itself with bed rest.