Pneumothorax
Reviewed by: Dr. Raúl David Vega Vivar · Thoracic Surgery · Specialty license 14842215
Last reviewed:
Description
Pneumothorax is air between the lung and the chest wall, in the pleural space. This air keeps the lung from fully expanding and can cause it to collapse partially or completely. It can occur with no apparent cause in young, healthy people (primary spontaneous pneumothorax), in people with a lung disease such as COPD (secondary spontaneous pneumothorax), or after a blow, a wound, or a procedure on the chest (traumatic pneumothorax).
When to go to the emergency room
Call 911 or go to the emergency room if you have:
- Sudden chest pain with shortness of breath
- Shortness of breath that returns after a pneumothorax
- Blue lips or skin
Causes
- Rupture of small bullae (air blisters) on the surface of the lung
- Lung diseases such as COPD, emphysema, fibrosis, or infections
- Blows or wounds to the chest, including broken ribs
- Medical procedures on the chest, such as a biopsy or catheter placement
Symptoms
- Sudden pain on one side of the chest that gets worse when breathing
- Shortness of breath
- Fast breathing and pulse
- Dry cough
- Tiredness
Diagnosis
It is confirmed with a chest X-ray. In some cases, an ultrasound or a CT scan is used to measure its size and look for the cause.
Treatment
Treatment depends on the symptoms more than on the size. A small pneumothorax with few symptoms can be monitored. If it causes shortness of breath, the air is removed with a needle or with a chest tube. When it recurs, or the air leak persists, minimally invasive surgery with pleurodesis is recommended to keep it from coming back. Quitting smoking reduces the risk that it comes back.
Reference guideline: BTS, pleural disease guideline, 2023; ERS, primary spontaneous pneumothorax, 2015.
Complications
- Tension pneumothorax: air compresses the lung and the heart; it is an emergency
- Air leak that does not close
- Recurrent pneumothorax
- Bilateral pneumothorax (uncommon)
Risk factors
- Smoking
- Having had a pneumothorax before
- Lung diseases such as COPD or asthma
- Family history of pneumothorax
Frequently asked questions
Is it an emergency?
It can be. If you have sudden chest pain with shortness of breath, go to the emergency room so you can have an X-ray.
Can it happen again?
Yes, especially in those who keep smoking. If it recurs, it is recommended to evaluate a definitive treatment to prevent new episodes.
Can I fly on a plane?
Not until your doctor confirms with an X-ray that the lung has fully expanded. Ask your doctor how long you should wait in your case.
When is surgery needed?
When the pneumothorax recurs, when the air leak does not close after a few days, or in people with risky activities, such as pilots or divers. It is done with minimally invasive surgery.
Sources: BTS (2023) · ERS (2015)
Conditions
Learn about other diseases
Pneumothorax can get worse quickly. If you have sudden chest pain with shortness of breath, go to the emergency room. If you have a pneumothorax that keeps coming back or does not resolve, book an appointment at AirCare Salud Respiratoria for an evaluation.
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