Collapsed Lung (Pneumothorax)

Topic Overview

What is a pneumothorax?

A collapsed lung (pneumothorax) is a buildup of air in the space between the lung and the chest wall (pleural space). As the amount of air in this space increases, the pressure against the lung causes the lung to collapse. This prevents your lung from expanding properly when you try to breathe in, causing shortness of breath and chest pain.

A pneumothorax may become life-threatening if the pressure in your chest prevents the lungs from getting enough oxygen into the blood.

What causes a pneumothorax?

A pneumothorax is usually caused by an injury to the chest, such as a broken rib or puncture wound. It may also occur suddenly without an injury (spontaneous pneumothorax).

Spontaneous pneumothorax can result from damage to the lungs caused by conditions such as chronic obstructive pulmonary disease (COPD), asthma, cystic fibrosis, and pneumonia. Spontaneous pneumothorax can also occur in people who don't have lung disease. This happens when an air-filled blister (bleb) on the lung ruptures and releases air into the pleural space.

People who smoke cigarettes are much more likely to suffer a spontaneous pneumothorax than those who don't. Also, the more you smoke, the greater your chances of having a pneumothorax.

What are the symptoms?

Symptoms depend on the size of the pneumothorax. In minor cases, you may not realize you have a pneumothorax. In more severe cases, symptoms will develop rapidly and may lead to shock.

Symptoms may include:

• Shortness of breath (dyspnea), which may be mild to severe, depending on how much of the lung is collapsed.
• Sudden, severe, and sharp chest pain on the same side as the collapsed lung.

Symptoms may become worse with altitude changes (for instance, flying in an airplane or going underground or underwater).

How is a pneumothorax diagnosed?

In most cases, a chest X-ray is used to diagnose a pneumothorax. Your health professional may also perform blood tests to measure the level of oxygen in your blood.

A computed tomography (CT) scan or ultrasound may be needed to diagnose the severity of your condition and help plan your treatment.

How is it treated?

A minor pneumothorax may only require observation by your health professional; in some cases, oxygen may be given (through a mask). More serious cases are treated by inserting a needle or a chest tube into the chest cavity. Both of these procedures relieve the pressure on the lung and allow it to re-expand.

Surgery may be needed if the original treatment does not work or if the pneumothorax returns. However, because no surgery is risk-free, most health professionals will suggest surgery only after you have had more than one spontaneous pneumothorax.¹

What are the chances that a pneumothorax will return?

If you have had one pneumothorax, you have an increased risk for another. Nearly all recurrences happen within 2 years of the first pneumothorax. If you smoke, quitting smoking can reduce your risk of another pneumothorax.

Spontaneous pneumothorax returns in about 20% to 30% of people who don't have lung disease. People with lung disease have a 40% to 50% chance of having another pneumothorax.¹

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Author:	Jan Nissl, RN, BS	Last Updated April 27, 2007
Medical Review:	William M. Green, MD - Emergency Medicine H. Michael O'Connor, MD - Emergency Medicine
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