PNEUMOTHORAX |
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General Information
DEFINITION--Collapse of part or all of a lung caused by pressure from free air in the chest between the two layers of the pleura (thin membranes that cover the lung). Peak incidence is in males between ages 20 to 40.
SIGNS & SYMPTOMSThe following symptoms vary according to the degree of lung collapse and extent of underlying lung disease. Symptoms may be less acute if the pneumothorax develops slowly:
Sharp chest pain. Pain may extend to a shoulder or across the chest or abdomen.
Shortness of breath and rapid breathing.
Dry, hacking cough (occasionally).
Bluish nails.
Coughing bloody sputum (sometimes).
Rapid pulse.
In worst cases (tension pneumothorax), fainting and shock.
CAUSES & RISK FACTORS SPONTANEOUS PNEUMOTHORAX:
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Physical exertion in a healthy individual, with no obvious preceding injury, infection or disease. Activities most likely to produce pneumothorax include:
Ascent while scuba diving.
Diving or high-altitude flying.
Activities that require stretching the chest and rib cage, such as track and field events, throwing sports and bowling.
Rupture of small air sacs in the lung. Asthma, emphysema, chronic bronchitis, lung abscess, empyema, or other lung disease may cause the rupture of air sacs. PNEUMOTHORAX DUE TO TRAUMA:
Penetrating wound to the chest, which permits outside air to rush into the pleural space and causes the lung to collapse.
Complication of removing fluid from the lung (thoracentesis).
HOW TO PREVENT
Learn and use proper techniques for activities at risk listed above (especially ascending in scuba diving).
Obtain medical treatment for lung disorders such as asthma or emphysema.
Don't smoke.
WHAT TO EXPECT
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and physical exam by a doctor.
X-rays of the chest to confirm the diagnosis.
SURGERYSometimes necessary to remove free air that has leaked out of the lungs into the chest.
NORMAL COURSE OF ILLNESSA small pneumothorax is inconsequential and heals itself. However, if the collapse is extensive and it occurs in middle-aged or older adults whose lungs are damaged by asthma, chronic bronchitis or emphysema, it can lead to respiratory failure and critical illness. Treatment depends on the size of the pneumothorax and the condition of the lungs.
POSSIBLE COMPLICATIONS
Respiratory failure.
Lung infection.
Recurrence of pneumothorax. If it is going to recur, 20% to 40% of cases usually do so within 2 years of initial pneumothorax.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
MEDICAL TREATMENTHospitalization and treatment with special equipment following minor surgery may be necessary.
HOME TREATMENT
Don't exercise during healing, but resume normal activities--including the one that triggered the pneumothorax--after clearance from your doctor.
Don't smoke.
Try not to cough.
Avoid loud talking, laughing or singing.
You may be more comfortable if you rest in a sitting or semi-reclining position.
MEDICATIONMedication usually is not necessary. However, you may use non-prescription drugs such as acetaminophen for minor pain. For severe pain, your doctor may prescribe stronger pain relievers.
ACTIVITYStay as active as your strength allows. Rest often. Resume your normal activities as soon as possible. Allow about 2 to 3 weeks for lung to re-expand. Allow 6 weeks before returning to maximal exercise.
DIETNo special diet.
CALL YOUR DOCTOR IF
You have symptoms of pneumothorax.
The following occurs during treatment:
Temperature rises to 101F (38.3C).
Chest pain or shortness of breath increases.
Painful, debilitating coughing or sputum production begins.
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