A collapsed lung, medically known as a pneumothorax, occurs when air leaks into the space between the lung and the chest wall. This space, called the pleural space, normally maintains a negative pressure that keeps the lung fully inflated. When air collects in this area, it creates a positive pressure that pushes against the lung, causing it to partially or fully deflate. The degree of this collapse affects the severity of symptoms and the immediate danger. Because a pneumothorax can rapidly impair the body’s ability to take in oxygen, it is considered a serious medical emergency requiring prompt attention.
Types and Triggers of a Collapsed Lung
Pneumothoraces are broadly categorized by how the air leak originates. A spontaneous pneumothorax occurs without any trauma or medical procedure and is divided into two types. Primary spontaneous pneumothorax happens in people without a known underlying lung condition, often due to the rupture of small, air-filled sacs called blebs on the lung surface.
Secondary spontaneous pneumothorax develops in individuals who already have a lung disease, such as chronic obstructive pulmonary disease (COPD) or cystic fibrosis, which weakens the lung tissue. A traumatic pneumothorax results from a direct injury to the chest, such as a rib fracture or a penetrating wound that punctures the lung or chest wall.
An iatrogenic pneumothorax is a specific traumatic collapse that occurs as a complication of a medical procedure, such as certain biopsies or the insertion of central lines. The tension pneumothorax is a particularly severe form that develops when a one-way valve effect traps air in the chest cavity, causing pressure to build relentlessly and push the heart and major blood vessels to the side.
Recognizing the Physical Signs and Symptoms
The first and most commonly reported indicator of a pneumothorax is a sudden, sharp chest pain that typically localizes to one side of the chest. This pain is often described as stabbing and tends to worsen significantly when the individual attempts to take a deep breath or cough. The onset of this sensation is usually immediate.
Following the onset of pain, the individual will experience shortness of breath (dyspnea), which can range from mild to severe. Because the lung cannot fully expand, the body struggles to take in enough oxygen, leading to an increased rate of rapid, shallow breathing (tachypnea) to compensate for the reduced lung capacity.
As the body’s oxygen levels fall, a person may also display a rapid heart rate (tachycardia). In more significant cases, a bluish discoloration of the skin, lips, or nail beds (cyanosis) may become noticeable due to the lack of sufficient oxygen. The chest may also feel tight or constricted.
In severe instances, a visible lack of movement or uneven rise on the affected side of the chest during inhalation can be observed. Other less specific symptoms may include lightheadedness or fatigue. If the air pressure inside the chest continues to rise, as in a tension pneumothorax, the symptoms will rapidly escalate, potentially leading to shock and collapse.
Immediate Steps and Emergency Care
If a collapsed lung is suspected based on the sudden onset of sharp chest pain and breathing difficulty, the most important immediate action is to call for emergency medical services (such as 911) without delay. A pneumothorax can progress quickly, especially into the life-threatening tension form, requiring prompt professional medical intervention to stabilize the condition.
While waiting for help to arrive, the individual should remain as calm as possible and avoid any unnecessary physical exertion. Movement and effort increase the body’s demand for oxygen, potentially worsening distress. Resting in a position that minimizes discomfort and facilitates breathing, such as sitting upright, is recommended.
Do not attempt to drive oneself to the hospital or rely on non-emergency transport, as the patient’s condition could deteriorate rapidly. Emergency medical technicians are equipped to provide supplemental oxygen and perform initial life-saving procedures, such as needle decompression for a suspected tension pneumothorax.
How Medical Professionals Confirm and Treat the Condition
Upon arrival at a medical facility, the diagnostic process begins with a physical examination, where a doctor may listen to the chest with a stethoscope for decreased or absent breath sounds on the affected side. The definitive confirmation of a pneumothorax is typically achieved through medical imaging.
A chest X-ray is the primary diagnostic tool, as it clearly visualizes the air pocket in the pleural space and the partially collapsed lung. For more complex cases, such as those involving underlying lung disease or trauma, a Computed Tomography (CT) scan may be used to provide a more detailed image of the lung tissue and the extent of the air leak. A lung ultrasound can also rapidly confirm the presence of air in the pleural space at the bedside. These imaging techniques help determine the size of the pneumothorax, which guides the choice of treatment.
Treatment varies based on the size of the collapse and the patient’s symptoms. A very small pneumothorax that causes minimal symptoms may only require observation and supplemental oxygen, which helps the body reabsorb the trapped air more quickly.
For larger collapses or those causing significant breathing difficulty, a procedure to actively remove the air is necessary. This may involve a needle aspiration, where a hollow needle and small catheter are inserted between the ribs to pull out the excess air. A more definitive treatment for larger or persistent leaks is the insertion of a chest tube, which is a flexible drain placed into the chest cavity to continuously remove air until the lung is fully re-expanded and the leak heals.