Pneumothorax (Collapsed Lung)

Medically Reviewed by Poonam Sachdev on May 01, 2024
Written by Kendall K. Morgan
7 min read

Pneumothorax, also called a collapsed lung, is when air gets between one of your lungs and the wall of your chest. It happens when air leaks out of your lungs.

The pressure from the air outside causes your lung to give way, at least partly. When this happens, you can inhale, but your lung can’t expand as much as it should.

If you have a collapsed lung, it may be a medical emergency. You should get help right away if you think that you may have pneumothorax.

Atelectasis vs. pneumothorax

Sometimes, a section of your lung or even your whole lung can collapse because of a blockage or a lack of pressure in tiny air sacs called alveoli inside your lung. This form of lung collapse is called atelectasis. Pneumothorax is one cause of atelectasis.

Atelectasis is a common complication of surgery and can also happen from other lung or breathing problems.

There are several types of pneumothorax. You could have one or more at the same time:

Simple. The tissues and organs between your lungs aren’t moved around.

Primary spontaneous. Your lung collapses without any clear injury, health condition, or other cause.

Secondary spontaneous or disease-related. Your pneumothorax happens from a lung disease or other condition.

Tension. Air keeps coming into your lungs but it can't get out, causing pressure to build in your chest.

Open. Air can move in and out through an open wound in your chest wall.

Traumatic or injury-related. An injury to your chest, such as a broken rib or stabbing, punctures your lung and causes the collapse.

Iatrogenic. Your lung gets punctured during a lung biopsy or other medical procedure.

Catamenial. It's rare, but this can happen when endometrial tissue grows outside your uterus to form cysts that bleed into the space outside your lungs.

Symptoms can range from mild to dangerous. If your case is mild, you may not notice a problem. Common symptoms include:

  • Bluish skin, nails, and lips
  • Chest pain, ache, or tightness, especially when you breathe in
  • Coughing
  • Fatigue
  • Fast breathing
  • Fast heartbeat
  • Shortness of breath
  • Shoulder pain
  • Lightheadedness or feeling like you are about to faint

If you notice these signs, it’s important to tell your doctor what’s happening or go to the closest emergency room. A collapsed lung can be a medical emergency.

You can get a pneumothorax in several ways. Causes include:

Lung disease. Lung 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 is a machine that helps you breathe and might create 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 of your period, the cysts release blood between the lung and chest.

Medical conditions that can cause pneumothorax include:

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

Injuries that can cause lung include:

  • Blunt force trauma
  • Gunshot wounds
  • Knife wounds

Medical procedures that can cause your lung to collapse include:

  • Nerve block
  • Lung biopsy
  • Central venous line placement
  • Mechanical ventilation
  • One-way valve therapy

Lifestyle factors or activities that can cause pneumothorax or make it more likely include:

  • Using drugs, especially if you inhale them
  • Smoking
  • Flying with big changes in air pressure
  • Scuba diving or deep-sea diving

Things that increase your risk of having a collapsed lung include:

  • A family history of collapsed lung
  • Pregnancy
  • Being tall and thin, especially if you are a male or were assigned male at birth
  • Marfan syndrome
  • Endometriosis

Often, someone who has a collapsed lung gets another one 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:

Observation

Your doctor will probably want you to stay in the hospital so they can watch your progress. To treat a collapsed lung, they get 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 such as 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 a 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, which is usually about 3 weeks after your lung has been repaired. On land, don’t go more than 7,500 feet above sea level.

Pneumothorax can be life-threatening. If treated, many people don’t have long-term health effects from a pneumothorax. But the lung can collapse again in up to 50% of cases.

You may spend time in the hospital for treatment so doctors can watch how you're doing.

If your lung is punctured, it may take up to 2 weeks to heal. Your body will reabsorb the air around your lungs so that you can fill them normally again.

Some serious complications that may come with a collapsed lung include:

  • Re-expansion pulmonary edema
  • Lung damage from treatment
  • Infection
  • Respiratory failure
  • Heart failure

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.

You can get pneumothorax if air leaks from your lung into the space outside due to many possible causes. If you think that your lung has collapsed, see a doctor right away or go to the emergency room. Pneumothorax usually doesn't cause long-term complications, but it can be life-threatening.

What is the best treatment for pneumothorax?

The best treatment for your pneumothorax will depend on what's causing it. See a doctor right away if you have pneumothorax or think that your lung may have collapsed.

How long does it take to recover from a pneumothorax?

Once you've gotten treatment for the cause of your collapsed lung, your lung will usually go back to normal in 2-3 days. But it could take you weeks to fully recover.

What is the most common cause of spontaneous pneumothorax?

In most cases, nobody knows what causes spontaneous pneumothorax. But some things can make it more likely to happen, including connective tissue disorders, smoking, scuba diving, and flying at high altitudes.

What is the life expectancy of someone with a pneumothorax?

Pneumothorax doesn't usually have long-term effects on your health. But its effect on you may depend on the cause and other health conditions you have. For example, one study found that spontaneous pneumothorax in patients with a connective tissue disorder is a sign they will have a worse outcome. People in the study whose lungs collapsed were more likely to die and had worse 10-year survival rates.