Collapsed lung

Definition

A collapsed lung, or pneumothorax, is the collection of air in the space around the lungs. This buildup of air puts pressure on the lung, so it cannot expand as much as it normally does when you take a breath.

Alternative Names

Air around the lung; Air outside the lung; Pneumothorax; Spontaneous pneumothorax

Causes, incidence, and risk factors

A collapsed lung may result from chest trauma, such as gunshot or knife wounds, rib fracture, or after certain medical procedures.

In some cases, a collapsed lung occurs without any cause. This is called a spontaneous pneumothorax. A small area in the lung that is filled with air, called a bleb, ruptures, and the air leaks into the space around the lung.

Certain activities may lead to a collapsed lung. These include scuba diving, smoking marijuana or cigarettes, high altitude hiking, and flying.

Tall, thin people are more likely to a collapsed lung.

Lung diseases such as COPD, asthma, cystic fibrosis, tuberculosis, and whooping cough also increase your risk for a collapsed lung.

Symptoms

Almost everyone who has a collapsed lung has the following symptoms:

• Sharp chest pain, made worse by a deep breath or a cough
• Shortness of breath

A larger pneumothorax will cause more severe symptoms, including:

• Chest tightness
• Easy fatigue
• Rapid heart rate
• Bluish color of the skin caused by lack of oxygen

Note: Symptoms may begin during rest or sleep.

Other symptoms that can occur with a collapsed lung include:

• Nasal flaring
• Low blood pressure (hypotension)

Signs and tests

There are decreased or no breath sounds on the affected side when heard through a stethoscope.

Tests include:

• Chest x-ray to tell whether there is air outside the lung
• Arterial blood gases

Treatment

A small pneumothorax may go away on its own. You may only need oxygen and rest. The health care provider may use a needle to pull the extra air out from around the lung so it can expand more fully. You may be allowed to go home if you live near the hospital.

If you have a large pneumothorax, a chest tube will be placed between the ribs into the space around the lungs to help drain the air and allows the lung to re-expand.

The chest tube can be left in place for several days. You must stay in the hospital while the chest tube is in place.

Some patients with a collapsed lung need extra oxygen, which helps the air around the lung be reabsorbed more quickly.

Lung surgery may be needed to treat your pneumothorax or to prevent future episodes. The area where the leak occurred may be repaired. Sometimes, a special chemical is placed into the area of the collapsed lung. This chemical causes a scar to form.

Expectations (prognosis)

If you have a collapsed lung, you are more likely to have another one in the future if you:

• Are tall and thin
• Continue to smoke
• Have had two collapsed lungs in the past

How well a person does after having a collapsed lung depends on what caused it.

Complications

• Another collapsed lung in the future
• Shock

Calling your health care provider

Call your health care provider if you have symptoms of a collapsed lung, especially if you have had one before.

Prevention

There is no known way to prevent a collapsed lung, but you can decrease your risk by not smoking.

References

Light RW, Lee GY. Pneumothorax, Chylothorax, Hemothorax, and Fibrothorax. In: Mason RJ, Murray JF, Broaddus VC, Nadel JA, eds. Textbook of Respiratory Medicine. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2005: chap 69.