What Is Pneumothorax (Collapsed Lung)?
Pneumothorax, also called a collapsed lung, is when air gets between one of your lungs and the wall of your chest. The pressure causes the lung to give way, at least partly.
When this happens, you can inhale, but your lung can’t expand as much as it should.
Sometimes, a section of your lung can collapse because of a blockage or a lack of pressure inside the lung, instead of pressure from outside the lung. That’s a condition called atelectasis.
Types of Pneumothorax
There are several types of pneumothorax. You could have one or more at the same time:
- Simple, in which the tissues and organs between your lungs aren’t moved around
- Primary spontaneous, when it happens without any clear cause
- Secondary spontaneous or disease-related
- Tension, when air continues to enter the space between your lung and your chest wall, raising pressure in your chest
- Traumatic or injury-related
Symptoms can range from mild to dangerous. If your case is mild, you may not notice a problem. That’s why it’s important to tell your doctor what’s happening. Common symptoms include:
- Bluish skin
- Chest pain, ache, or tightness
- Fast breathing
- Fast heartbeat
- Shortness of breath
Pneumothorax Causes and Risk Factors
You can get pneumothorax several ways. Causes include:
- Lung disease. Tissue that’s damaged is more likely to tear, allowing air to leak out. This is especially true with chronic obstructive pulmonary disease (COPD).
- Injury. A broken rib, knife wound, or gunshot wound can puncture your lung. In severe cases, the escaping air can build up pressure on your lung and heart, which might cause life-threatening problems such as loss of blood pressure.
- Mechanical ventilation. This machine that helps you breathe creates uneven pressure in your chest. As a result, your lung might collapse.
- Air blisters. Sacs full of air, called blebs, may form on the outside of your lung and then burst, creating pressure. This happens most often with tall men who are younger than 40 and who smoke.
- Your period. It’s rare, but cysts could form inside your chest. Within about 3 days before or after the start your period, the cysts release blood between the lung and chest.
Often, someone who has a collapsed lung gets another within 1 or 2 years. Smoking can also make the condition more likely. And some types of pneumothorax run in families.
Your doctor will probably start with a physical exam. They’ll listen to your breathing through a stethoscope and tap your chest to find out if it sounds hollow.
You might have tests including:
- X-rays so your doctor can see the outline of your lung
- A CT scan, a series of X-rays that a computer turns into a detailed image of your lung
- Arterial blood gas or pulse oximetry to measure how much oxygen is in your blood
- EKG to check how well your heart is working
Your treatment will depend on the type of pneumothorax and how severe it is. You may have one or more of these:
Your doctor will probably want you to stay in the hospital so they can watch your progress. They treat a collapsed lung by getting rid of the pressure outside the lung so it can inflate again.
In minor cases without symptoms, the lung can expand again on its own. You may need to breathe oxygen from a container for a short time to help. Even if your case is mild, it’s important to have follow-up visits with your doctor so they can keep track of how you’re doing.
Needle aspiration or chest tube insertion
If your lung has collapsed further, your doctor may use a needle or a tube to release the extra air from your chest. The tube might be attached to a one-way valve. It could have to stay in place for hours or days.
Autologous blood patch
Your doctor can take blood from your arm and put it into your chest through a tube. This makes a patch on your lung that stops air leaks.
Surgery or pleurodesis
Cases involving lung disease, an accident, or repeated collapsed lungs may need surgery. Or you could have a procedure called pleurodesis. Your doctor uses a needle and tube to put medicine like doxycycline into your chest. It triggers inflammation, which helps your lung stick to the chest wall and stay inflated.
It usually takes 1 or 2 weeks to recover from pneumothorax. But you have to wait for your doctor to say you’re OK. Until then:
- Go back to your routine a little bit at a time. Go for walks or do other low-impact activities.
- Monitor your symptoms. Watch for chest pains or other signs that you haven’t healed, such as a fever or coughing up blood.
- Lift only light objects. Don’t pick up anything heavier than a gallon of milk. Don’t vacuum or mow the grass.
- Be careful how you exercise. Don’t do anything that jars your body, such as running or biking. Don’t play contact sports.
- Remember air pressure. Don’t get on an airplane until your doctor gives the OK, usually about 3 weeks after your lung has been repaired. On land, don’t go more than 7,500 feet above sea level.
With treatment, many people don’t have long-term health effects from pneumothorax. But it can happen again in up to 50% of cases.
If you've had a collapsed lung, you need to take extra care of yourself to keep it from happening again. Some tips:
- If you smoke, ask your doctor for help quitting.
- If you scuba dive, your doctor might tell you to stop.
- If you have a lung problem, keep up with your medical visits.