Pneumothorax awareness

Overview

Pneumothorax, also called a collapsed lung, happens when air leaks into the space between your lung and your chest wall. This air pushes on the outside of your lung and makes it collapse, like a deflated balloon.

Pneumothorax is not very common, but it can affect anyone. About 1 in 100,000 people have a spontaneous pneumothorax each year.

It occurs most often in young, tall, thin men between the ages of 20 and 40, and in older adults with lung disease such as COPD or cystic fibrosis. Smokers are at significantly higher risk.

Symptoms

Common symptoms

• Sudden sharp chest pain that often gets worse when you cough or take a deep breath
• Shortness of breath
• Rapid heart rate

Symptoms in children

• Fussiness or irritability
• Rapid breathing
• Chest pain, though younger children may not be able to describe it clearly

Symptoms in older adults

• Shortness of breath that may be confused with a flare-up of another lung condition
• Fatigue
• Confusion or dizziness

Causes

Main causes

• Spontaneous – happens for no clear reason, often in tall thin people or smokers
• Trauma – such as a rib fracture or puncture wound
• Lung disease – like COPD, asthma, tuberculosis, or cystic fibrosis

Risk factors

• Smoking cigarettes
• Tall, thin body type
• Family history of pneumothorax
• Scuba diving or flying in unpressurized aircraft with a lung condition

When to see a doctor

See a doctor urgently if:

• If you have sudden chest pain and trouble breathing, seek care right away – call your local emergency number.
• If you have a known pneumothorax and your symptoms worsen suddenly.

Book a routine appointment if:

• If you have mild chest pain or shortness of breath that lasts more than a few days, make an appointment with your GP.

Diagnosis

Your doctor will listen to your lungs with a stethoscope and may notice that one side doesn't sound as clear. They will likely order a chest X-ray to see the air leak.

Tests that may be done

• Chest X-ray – the most common test to see the collapsed lung
• CT scan – a more detailed scan if the X-ray is unclear or to check for underlying disease
• Ultrasound – sometimes used in emergency settings

What to expect at your appointment

The doctor will ask about your symptoms and medical history. The tests are quick and painless. You may need to wait for results, and if the pneumothorax is large, treatment may start right away.

Treatment

Treatment depends on the size of the pneumothorax, whether it is getting worse, and your overall health. Small ones may only need observation, while larger ones require a procedure to remove the air.

Self-care at home

• Rest and avoid heavy lifting or strenuous activity until your doctor says it's safe.
• Do not smoke – smoking worsens the risk and slows healing.
• Avoid flying or scuba diving until fully healed.

Medical treatments

A doctor may use a needle to draw out the air (needle aspiration) or place a tube (chest drain) to let the air escape for a few days. In some cases, the lung may need to be re-expanded using suction. Pain relief and oxygen may be given.

When is surgery considered?

Surgery may be recommended if you have had pneumothorax more than once, if the lung does not re-expand with a chest tube, or if a bleb (a small air-filled blister) is found on the lung. The procedure often involves removing the bleb and attaching the lung to the chest wall to prevent recurrence.

Living with this condition

After treatment, most people recover fully. You may need to take a few weeks off work or school. Your doctor will tell you when it's safe to return to normal activities.

Lifestyle tips

• Stop smoking – this is the most important step to reduce your risk.
• Avoid activities with rapid pressure changes, such as scuba diving, flying in unpressurized aircraft, or climbing high mountains.
• Stay active but listen to your body – stop if you feel pain or shortness of breath.

Diet and exercise

There is no special diet for pneumothorax, but eating well supports overall healing. Gentle exercise, like walking, is fine once your doctor approves. Avoid contact sports until fully healed.

Mental health and emotional wellbeing

A collapsed lung can be frightening, and worry about it happening again is common. It's normal to feel anxious. Talk to your doctor or a counsellor if anxiety affects your daily life.

Prevention

You cannot always prevent a pneumothorax, but you can lower your risk by not smoking and by managing any lung disease you have. Avoid scuba diving if you have a history of pneumothorax.

Vaccines

Vaccines that protect against respiratory infections (like the flu vaccine and pneumonia vaccine) may reduce the risk of lung problems that could lead to pneumothorax. Ask your doctor for advice.

Screening programmes

There is no routine screening for pneumothorax in the general population. If you have a family history or lung disease, your doctor may monitor you with regular check-ups.

Complications

If left untreated

• Tension pneumothorax – a build-up of air that puts pressure on the heart and other lung, which is life-threatening and requires immediate emergency treatment.
• Recurrence – pneumothorax can come back, especially in smokers or people with blisters on the lung.

Long-term outlook

Most people who have a pneumothorax recover well with prompt treatment. The outlook is generally good, though the chance of it happening again is higher in some individuals. Quitting smoking and following your doctor's advice can greatly improve your long-term health.

Find support

Local organisations

• NHS – Pneumothorax information ↗ · United Kingdom

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