Have you heard of a collapsed lung? (Pneumothorax/Collapsed Lung) Let's talk about this!

Have you ever heard of a lung suddenly collapsing? Sometimes it can be difficult to breathe and cause chest pain. This is what we call a “pneumothorax” or “collapsed lung ” in medical terms. It’s actually not as rare as you might think. So, it’s important to be aware of this. Let’s talk about it in detail and simply today, shall we?

What is pneumothorax? Simply put…

Simply put, a pneumothorax is the accumulation of air in the space between your lung and your chest wall (called the “pleural space”) . Think of your lung as a balloon. The pleural space is the small space between the balloon and the box that holds the balloon. Normally, there isn’t much air in this space. However, if this pleural space somehow fills with air, the air pushes on the lung. It’s like inflating a balloon and causing it to deflate. This can cause the lung to collapse completely or partially. Some people also call this a “punctured lung.”

The important thing is that pneumothorax can sometimes be a medical emergency . If you feel like your lung is collapsing, you should go to the emergency department of your nearest hospital as soon as possible.

Are there types of pneumothorax?

Yes, there are two main types of pneumothorax: Spontaneous and Traumatic . Let's see what these are.

1. Spontaneous Pneumothorax

This occurs when the lungs collapse spontaneously without any injury or danger. There are also subtypes of this:

• Primary spontaneous pneumothorax: In this, there is no underlying disease or condition that causes the lung to collapse. Sometimes small, abnormal air sacs (blebs ) in the lung can burst and air can enter the pleural space. This is more likely to happen in tall, thin, young men.
• Secondary spontaneous pneumothorax: This occurs due to a lung disease. For example, some lung diseases can cause parts of the lung to become blocked, forming balloon-like sacs (bullae) that can burst.

2. Traumatic Pneumothorax

As the name suggests, this happens due to an injury or medical treatment.

• Injury -related pneumothorax: This condition can occur due to an injury to the chest, such as a broken rib in a car accident, a punctured lung, or a stab wound.
• Iatrogenic pneumothorax: Sometimes, during a medical procedure, such as taking a small sample of the lung for testing ( a lung biopsy ) or inserting a tube into a large vein in the neck (a central venous line), the lung can be injured unintentionally.

There are other specific types of pneumothorax:

• Tension pneumothorax: This is a very dangerous condition that requires immediate medical attention . What happens here is that air gets into the pleural space, but there is no way to get out. It's like a one-way valve. Then the pressure inside the chest increases greatly , not only causing the lungs to collapse further, but also putting pressure on the heart and large blood vessels . This can be life-threatening.
• Catamenial pneumothorax: This is a very rare condition. It can occur in women with a condition called endometriosis (growth of endometrial tissue outside the uterus). This tissue can grow in the pleural space, bleed during the menstrual cycle, and compress the lung.

How serious is a collapsed lung?

The severity of this depends on the cause and how much the lung has collapsed. Some minor cases are not serious and may resolve on their own. But some, especially tension pneumothorax , are serious conditions that require emergency medical treatment. A doctor can tell you exactly how much your lung has collapsed and what treatment is needed.

What are the symptoms of a pneumothorax?

When a lung collapses, symptoms such as:

• Pain on one side of the chest , especially when breathing.
• Cough.
• Rapid breathing .
• Heart rate increases.
• Tiredness, fatigue.
• Difficulty breathing (“dyspnea”).
• Blue discoloration of the skin, lips, or fingernails ( “cyanosis” ) – This means the body is not getting enough oxygen.

If you have these symptoms, go to the nearest hospital immediately. You may need urgent treatment .

What are the causes of pneumothorax?

There are three main causes: certain medical conditions, injuries, and certain lifestyle factors.

Medical conditions:

• Asthma
• Pneumonia
• COPD (Chronic obstructive pulmonary disease)
• Collagen vascular disease
• Cystic fibrosis
• Emphysema
• Idiopathic pulmonary fibrosis
• Lung cancer
• Lymphangioleiomyomatosis
• Tuberculosis
• Acute respiratory distress syndrome (ARDS )

Injuries:

• Blunt force trauma to the chest.
• A gunshot.
• Injuries caused by a sharp weapon, such as a stab wound.
• Medical treatment, for example, a nerve block, lung biopsy, central venous line placement , or mechanical ventilation .

Lifestyle factors:

• Drug use, especially inhalant drugs.
• Smoking.
• Large air pressure changes that occur during airplane travel.
• Scuba or deep-sea diving.

Who is most at risk for this condition?

You may be more likely to develop a pneumothorax if you:

• If someone in your family has had pneumothorax before (family history).
• During pregnancy.
• If you have a tall, thin body, especially if you are a man.
• If you have connective tissue diseases such as Marfan syndrome .
• If you have endometriosis .

What are the possible complications of a collapsed lung?

Although most cases of lung collapse resolve without problems, some people can develop serious complications. These include:

• Re-expansion pulmonary edema .
• Lung damage or infection during treatment.
• Respiratory failure .
• Heart failure.

How is pneumothorax diagnosed?

Doctors usually diagnose this by listening to your lungs and using imaging tests such as chest X-rays , CT scans ( computed tomography scans ), or lung ultrasound . Sometimes they may also do an “arterial blood gas” test to check the levels of oxygen and carbon dioxide in your blood.

Your doctor will ask about your lung conditions and perform a physical exam. Some types, such as tension pneumothorax, can be diagnosed based on symptoms alone.

How is pneumothorax treated?

The treatment you receive will depend on the cause, size, and severity of the pneumothorax. These treatments may include:

• Observation: If your pneumothorax is small, your doctor will observe you, looking for any heart or breathing problems, and will ask you to come back for a follow-up visit.
• Oxygen therapy.
• Thoracentesis: This involves inserting a temporary needle between the ribs on the side of the pneumothorax to remove the air that has accumulated in the chest.
• Chest tube drainage: If you have a large pneumothorax, your doctor will place a tube ( chest tube ) in your chest to reduce the amount of air in the pleural space. As the air pressure decreases, the lung can re-inflate and heal. This tube may be left in place for several days or longer.
• Chemical pleurodesis: To prevent the lung from collapsing again, a doctor may perform a procedure called pleurodesis . In this procedure, the doctor makes a small incision in the chest and inserts a tube. Then, using a chemical (such as doxycycline or talcum powder) , the lung is connected to the chest cavity. This eliminates the extra space.

Some people may need surgery to repair the damage to their lungs and heal. Surgery may be needed in the following cases:

• If air continues to leak from the chest tube.
• If the lungs do not inflate even after the chest tube is inserted.
• If the lungs contract repeatedly.
• If there is pneumothorax in both lungs.
• If the lungs are severely injured.

Can pneumothorax be prevented?

You can do these things to reduce the risk of a collapsed lung:

• Don't smoke. This is the most important thing.
• Avoid or limit activities that involve large changes in air pressure (such as deep-sea diving, air travel). If you do these things, follow your doctor's advice.
• If you have lung diseases, see your doctor regularly to monitor them.

However, if you have certain medical conditions or a family history of pneumothorax, it may not be possible to prevent it.

What to expect if you have a pneumothorax?

If you have a collapsed lung, you may need to stay in the hospital for a few days or longer for treatment and observation. Your doctor can then monitor your condition and give you oxygen if needed.

How long does it take for a lung to heal?

In most cases, the lungs can heal within a few days to two weeks. Your body will reabsorb the extra air that has accumulated around the lungs, allowing them to inflate again.

Can a lung heal completely?

Most people recover from this condition without any major treatment. However, there is a chance that it will recur. So, talk to your doctor about the chances of recurrence and what to do if symptoms return.

Is pneumothorax life-threatening?

Some cases of pneumothorax can be life-threatening. Therefore, never take a collapsed lung lightly. Always seek medical attention.

How do I take care of myself?

After you come home from the hospital, it's very important to take care of yourself as your doctor tells you. They may tell you to rest, limit or stop certain activities. For example:

• Smoking.
• Flights.
• Deep sea diving.

After you return home, be sure to go to the doctor on every scheduled day.

When should I see my doctor?

See your doctor if your symptoms recur or get worse. If you have had a pneumothorax before, you are at risk for another one.

When should I go to the Emergency Department (ETU)?

If you have symptoms of a collapsed lung (such as chest pain, difficulty breathing), go to the emergency room immediately. You may need urgent treatment.

What questions should I ask my doctor?

It may be helpful to ask your doctor questions like these:

• What is causing my lungs to shrink?
• Is there anything I can do to prevent a lung from shrinking again?
• What treatment options do I have?
• If I have to have a chest tube inserted, how long will it stay in?
• Will I need supplemental oxygen?
• Will I have to stay in the hospital?
• What kind of care will I need after treatment?
• What kind of care will I need after leaving the hospital or clinic?
• What should I not do after treatment?

Finally, remember (Take-Home Message)

Most of the time, a pneumothorax can be treated with minimal treatment. However, any lung collapse should be treated as a medical emergency until you know more about it. If you have symptoms of a lung collapse, such as chest pain or difficulty breathing, seek medical attention immediately. Your doctor can determine the best treatment for you. Don't panic, but don't delay either. The most important thing is to act quickly.