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Pneumothorax is a condition in which air leaks outside of the lungs and collects in the pleural space between the lungs and chest wall. This air can put extreme pressure on the lung, causing it to collapse.
What are the different types of pneumothorax?
Pneumothorax generally has two broad categories depending on the cause, namely, spontaneous pneumothorax (without injury) and traumatic pneumothorax (related to injury).
Spontaneous pneumothorax is further divided into:
- Primary spontaneous pneumothorax: This occurs in patients without a known lung disease.
- Secondary spontaneous pneumothorax: This occurs in patients who have an underlying lung condition, such as COPD, cystic fibrosis, and cystic lung disease.
Traumatic pneumothorax is further divided into:
- Iatrogenic: Develops after a procedure or surgery in the lungs or when patients are placed on a ventilator (breathing machine).
- Non-iatrogenic: Develops after an accident or injury to the chest. (1)
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What are the causes of pneumothorax?
Pneumothorax can develop after a chest or lung injury, generally from an accident or surgery/procedure done near the lungs.
It can also develop without injury in patients with certain underlying conditions, which include:
- Chronic obstructive pulmonary disease (COPD), which is caused by smoking
- Cystic fibrosis, a congenital condition in children that causes lung injury and frequent infections
- Lung infections
- Cystic lung disease, a condition in which the lung has abnormal air-filled pockets that can burst open
Rarely, patients can develop pneumothorax without any identifiable cause.
What are the symptoms of pneumothorax?
Pneumothorax can occur without any symptoms, especially if the lung collapse is mild or limited.
Otherwise, the condition is characterized by shortness of breath and sharp, stabbing chest pain on the side of the pneumothorax. Both these symptoms usually have a sudden onset.
How is pneumothorax diagnosed?
Pneumothorax is usually diagnosed with a chest X-ray. At times, it can be diagnosed with an ultrasound or CT scan of the lung.
What is the treatment for pneumothorax?
Pneumothorax treatment depends on the cause and size of the pneumothorax.
Patients with a small pneumothorax without any symptoms can often be managed by giving extra oxygen and monitoring with repeated chest X-rays to see if the condition is resolving on its own.
Patients with a large pneumothorax or symptoms from the condition usually require removal of air from the cavity around the lung. Depending on the size and cause, occasionally, the air can be sucked out using a needle.
In most cases, however, the treatment requires placement of a small tube in the lung cavity through a hole between the ribs to remove the air. This tube generally stays for a few days until all the air is drained out and the leak in the lung has healed. (2)(3)
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What lifestyle changes should be made when suffering from pneumothorax?
Patients should try to refrain from smoking tobacco or other substances as they have shown to increase the chances of developing a pneumothorax.
Can pneumothorax heal itself?
Yes. Depending on the cause and size of pneumothorax, it can heal itself with supplemental oxygen and time.
What is the difference between tension pneumothorax and pneumothorax?
Tension pneumothorax develops when the pressure inside the lung cavity exceeds atmospheric pressure.
Trapped air under high pressure in the lung cavity can lead to a complete collapse of the lung and can prevent blood flow to the heart chambers, which in turn could keep the heart from pumping effectively.
Tension pneumothorax is a medical emergency, which can cause significant breathing difficulties, low oxygen levels in the body, and very low blood pressure. It usually happens when patients are on a ventilator in the intensive care unit (ICU).
What precautions should be taken when suffering from pneumothorax?
Once discharged from the hospital, the patient should continue to follow up with their healthcare provider to ensure adequate treatment for pneumothorax, and if they have any underlying lung condition.
Patients who had pneumothorax in the past should discuss with their healthcare provider before air travel or scuba diving as it can increase the chances of pneumothorax recurrence.
Be aware of the symptoms of pneumothorax, and contact your healthcare provider right away if there is any sudden onset of shortness of breath or chest pain.
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Is a collapsed lung the same as pneumothorax?
Pneumothorax is a condition in which air collects between the lung and chest wall. When this trapped air puts pressure on the lung, it can eventually collapse.
What are the complications of pneumothorax?
Pneumothorax can cause shortness of breath, chest pain, and low oxygen level.
Depending on the cause of pneumothorax, it can happen again in the future. Patients who had pneumothorax in the past should discuss their condition with their healthcare provider.
Why is pneumothorax common in tall, thin men of 20 to 40 years of age?
Primary spontaneous pneumothorax (PSP), which develops without injury in patients without an underlying lung condition, is more common in tall, thin men of 20 to 40 years of age. (4)
PSP generally happens from the rupture of small blebs (air pockets between lungs and pleura) in the cavity between the lung and chest wall.
It is hypothesized that tall men tend to have more blebs on top of the lung due to the increased stretch during lung development.
Are smokers prone to pneumothorax?
Yes. Smokers are prone to have PSP as smoking causes airway inflammation. In fact, most people who develop PSP tend to be smokers.
In one study, authors showed smoking increased the relative risk of developing PSP 9 times higher in women and 22 times higher in men. (5)(6)
Can high-stress levels lead to pneumothorax?
No, stress does not contribute to the development of pneumothorax.
Are dietary changes helpful in treating pneumothorax?
No, your diet has no connection with the development of pneumothorax.
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What precautionary measures should be taken against pneumothorax?
Pneumothorax can happen due to a variety of reasons, ranging from smoking, underlying lung disease, and trauma procedure, and sometimes the cause may remain unidentified.
Please seek medical care if you develop any new-onset shortness of breath or chest pain.
If you develop a pneumothorax, please consult your healthcare provider to determine the potential cause and treatment options, which can differ for each patient.
Refrain from smoking and discuss with your doctor before any air travel or scuba diving.
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