15304 Collapsed Lung Pneumothorax

Overview

A pneumothorax, also called a collapsed lung, happens when air leaks into the space between your lung and your chest wall. This air pushes on your lung, making it collapse either partially or fully. It can happen suddenly, causing chest pain and trouble breathing.

Yes, pneumothorax is fairly common. Around 5,000 to 8,000 people in the UK get it each year, though many countries see similar numbers. It is more common in certain groups, such as young, tall, thin men.

Anyone can get a collapsed lung, but it happens most often in tall, thin people under the age of 30, especially men. It also affects people with lung diseases like COPD or cystic fibrosis, and people who smoke. People who have had a pneumothorax before are at higher risk of getting it again.

Symptoms

Common symptoms

• Sudden sharp chest pain that feels worse when you breathe in deeply, cough, or move
• Shortness of breath or rapid breathing
• A feeling of tightness or pressure in your chest
• Fatigue or feeling unusually tired
• A dry, hacking cough (less common)

Symptoms in children

• Sudden chest pain or belly pain
• Fast or labored breathing
• A bluish tint to the lips or skin
• Irritability or unusual drowsiness
• Difficulty feeding in infants

Symptoms in older adults

• Shortness of breath that may be more noticeable than pain
• Rapid heart rate and low blood pressure
• Confusion or feeling lightheaded
• Chest pain that may be less sharp than in younger people

Causes

Main causes

• Injury to the chest, such as a broken rib, stab wound, or car accident
• Lung diseases like COPD, asthma, cystic fibrosis, or tuberculosis
• Medical procedures, such as a biopsy of the lung or being on a ventilator
• Spontaneous pneumothorax, which happens without any obvious cause, usually due to a tiny air blister (bleb) that bursts on the lung

Risk factors

• Smoking, which damages lung tissue
• Being tall and thin, especially for young men
• A family history of pneumothorax
• Having had a pneumothorax before
• Activities that involve rapid pressure changes, such as scuba diving or flying at high altitude
• Certain connective tissue disorders, like Marfan syndrome

When to see a doctor

See a doctor urgently if:

• If you have sudden chest pain or new difficulty breathing, go to your nearest emergency department or call your local emergency number.
• If you have been treated for a pneumothorax and your symptoms get worse, seek medical care immediately.

Book a routine appointment if:

• If you have had a pneumothorax before, make a follow-up appointment to discuss how to lower your risk of another one.
• If you have lung disease and notice new or unusual chest symptoms, schedule a check-up with your doctor.

Diagnosis

Your doctor will ask about your symptoms and medical history, listen to your chest with a stethoscope, and check your oxygen levels. They will usually order an imaging test to see if air is around your lung.

Tests that may be done

• Chest X-ray, which is the most common test to see a pneumothorax
• CT scan, which gives a more detailed image and can find small air leaks
• Ultrasound, sometimes used in emergency settings
• Pulse oximetry, to measure how much oxygen is in your blood
• Electrocardiogram (ECG), to check your heart if your symptoms could be heart-related

What to expect at your appointment

If your doctor suspects a pneumothorax, you will likely be seen quickly, often in an emergency department. The examination and imaging are usually done within a few hours. You may need to stay in the hospital for observation or treatment, but this depends on the size of the pneumothorax and how you are feeling.

Treatment

Treatment for a collapsed lung depends on how much of the lung has collapsed, what caused it, and how you are feeling. A very small pneumothorax may not need anything except rest and oxygen. A larger one may require a procedure to remove the air and help your lung re-expand.

Self-care at home

• Rest and avoid heavy lifting or strenuous activity while you heal.
• Do not smoke, as it slows healing and raises your risk of another pneumothorax.
• Take pain relief exactly as your doctor or pharmacist recommends — do not exceed the recommended dose.
• Follow your doctor's instructions about when it is safe to fly, dive, or exercise.
• Watch for worsening symptoms, and seek urgent help if they occur.

Medical treatments

For a larger pneumothorax, a doctor may use a needle to draw out the air (needle aspiration), which can be done at the bedside. Sometimes they insert a small tube called a chest drain to let air escape for a day or two. You may also receive extra oxygen from a mask. These approaches help the lung re-expand and usually do not require surgery. Medicines are sometimes given for pain or to prevent anxiety, but your care team will decide what is appropriate for you.

When is surgery considered?

Surgery is considered if you have a pneumothorax that keeps coming back, if the air leak continues despite a chest tube, or if both lungs are affected. The operation usually involves removing any small blisters on the lung and attaching the lung surface to the chest wall to prevent future collapse. This is generally done using small incisions (keyhole surgery) and has a good success rate.

Living with this condition

Recovery from a pneumothorax takes time — often several weeks. You will need to take it easy, get plenty of rest, and slowly build back your usual activities. Your doctor will tell you when you can return to work, school, and exercise. Do not ignore chest pain or breathlessness during recovery.

Lifestyle tips

• If you smoke, quitting is the single best thing you can do to protect your lungs and reduce the risk of another pneumothorax.
• Avoid scuba diving forever after a spontaneous pneumothorax, because the pressure changes can trigger another one.
• Do not fly in an airplane until your doctor says it is safe, usually after your lung has fully healed.
• Avoid contact sports or heavy weightlifting until you get the all-clear from your healthcare team.

Diet and exercise

Eat a balanced diet with plenty of fruits, vegetables, and whole grains to help your body heal. Start with gentle walking as soon as your doctor approves. Wait for your doctor's permission before doing vigorous exercise or lifting heavy weights. Follow a gradual return plan so you don't put too much strain on your lungs too soon.

Mental health and emotional wellbeing

Going through a collapsed lung can be frightening and stressful. It is normal to feel anxious, especially about it happening again. Talk to your doctor if you feel worried or low. They can offer reassurance and support. Connecting with others who have had similar experiences can also help.

Prevention

You cannot always prevent a pneumothorax, but you can lower your risk. Not smoking is the most important step. If you have had a pneumothorax, avoid activities like scuba diving and high-altitude flights until your doctor gives you the go-ahead. Wearing seatbelts and protective gear during contact sports can also help prevent chest injuries.

Vaccines

Getting recommended vaccines, such as the flu and pneumonia vaccines, can help protect your lungs from infections that might make a pneumothorax more likely, especially if you have chronic lung disease. Ask your doctor about which vaccines are right for you.

Screening programmes

There is no routine screening test for pneumothorax in the general population. If you have a family history of pneumothorax or a connective tissue disorder, your doctor may suggest regular check-ups to monitor your health.

Complications

If left untreated

• A tension pneumothorax, which is a medical emergency where pressure inside the chest keeps rising and can compress your heart and other lung
• Respiratory failure, when your lungs cannot get enough oxygen into your blood
• Infection in the chest cavity (empyema)
• Ongoing air leak that does not heal
• Collapse of the other lung or re-collapse of the same lung

Long-term outlook

The outlook for a pneumothorax is generally very good. Most people recover completely with treatment or even on their own if the collapse is small. The main concern is that it can come back — around 1 in 3 people who have one spontaneous pneumothorax will have another. But with good follow-up and healthy lifestyle choices, many people never have a second one. Your doctor can help you understand your personal risk and create a plan to stay well.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.