The difference between tension pneumothorax and open pneumothorax.

Written by Zhang Zhi Gong

Cardiothoracic Surgery

Updated on December 12, 2024

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The main difference between a tension pneumothorax and an open pneumothorax lies in the relative pressures of the pleural cavity compared to the atmospheric pressure. An open pneumothorax occurs when the pleural cavity is in an open state due to some reason. During inhalation, gas can enter the pleural cavity, and during exhalation, the gas can be expelled through this opening or another opening, resulting in pleural cavity pressure that is roughly equal to the atmospheric pressure. In a tension pneumothorax, due to some reason, a one-way valve is formed. The gas enters the pleural cavity easily but encounters resistance during expulsion, causing the pressure in the patient's pleural cavity to increase progressively. The gas can only enter the pleural cavity and cannot be effectively expelled. Therefore, the main difference between a tension pneumothorax and an open pneumothorax is the level of pleural cavity pressure compared to atmospheric pressure; in a tension pneumothorax, the pressure in the pleural cavity is significantly higher than the atmospheric pressure, while in an open pneumothorax, the pressures are roughly equal.

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Written by Yuan Qing

Pulmonology

58sec

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Pneumothorax clinical manifestations

Pneumothorax is primarily caused by various factors, both internal and external to the lungs, leading to a significant accumulation of gas within the chest cavity. Patients exhibit symptoms such as chest tightness, breathlessness, including coughing, chest pain, and other related symptoms, which are collectively referred to as pneumothorax. Patients with pneumothorax can be classified into mild and severe types. Generally, after the onset of pneumothorax, patients who only experience symptoms like panting, chest tightness, chest pain, or coughing, but maintain stable blood pressure and heart rate, are considered to have a mild condition. However, if in addition to these respiratory symptoms, the patient clearly exhibits a drop in blood pressure, a decrease in oxygen saturation, or a reduction in heart rate, these conditions are considered severe and require urgent treatment.

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Written by Zhang Zhi Gong

Cardiothoracic Surgery

1min 32sec

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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 Wang Xiang Yu

Pulmonology

46sec

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Pneumothorax should be registered under which department?

What department should you register for pneumothorax? If pneumothorax occurs suddenly, the condition is generally severe with significant breathing difficulties. In such cases, we recommend prioritizing a visit to the emergency department. Once the emergency department receives the patient, they will immediately request a consultation with a thoracic surgeon or a respiratory specialist. If the patient requires surgery, such as thoracic closed drainage or other procedures, it is usually handled by a thoracic surgeon; if the patient only requires conservative treatment, they will likely be transferred to the respiratory department; if the patient's condition is critical, they might be admitted to the ICU.

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Written by Han Shun Li

Pulmonology

47sec

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Can you smoke with pneumothorax?

After suffering from pneumothorax, patients often experience symptoms such as chest pain, chest tightness, and coughing. Can patients smoke after suffering from pneumothorax? It is advised against smoking after suffering from pneumothorax, as smoke and harmful substances directly irritate the respiratory tract, worsening the patient's symptoms. Additionally, smoking produces a large amount of carbon monoxide, which, when absorbed by the body, can cause hypoxia, thereby exacerbating symptoms of breathing difficulty. Therefore, patients with pneumothorax should not smoke, and it is also recommended to quit smoking even after recovery from pneumothorax, as smoking is harmful in many ways and particularly damaging to the respiratory system.

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Written by Zhang Zhi Gong

Cardiothoracic Surgery

1min 11sec

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Can pneumothorax be inherited?

In fact, medicine has found that most diseases, other than traumatic ones caused by injuries or car accidents, are related to genes or heredity. For instance, diseases like diabetes and hypertension clearly have a familial hereditary history. Pneumothorax is no exception, as it also tends to cluster in certain families, or has a higher tendency than in normal families. Therefore, pneumothorax does possess a certain hereditary nature, particularly in families prone to connective tissue disorders such as Marfan Syndrome. Additionally, pneumothorax often occurs in families with mutations in the human leukocyte antigen, and in those with conditions such as homocystinuria or antitrypsin deficiency, where pneumothorax is more prevalent. Of course, there are also conditions like Marfan Syndrome and Birt-Hogg-Dube (BHD) Syndrome in these families, which also tend to develop renal cysts, renal tumors, and skin fibrofolliculomas. Thus, the more frequent occurrence of pneumothorax in these families demonstrates that pneumothorax is genetically related and has a certain degree of heredity.