What is Pneumothorax?

Symptoms to Look For

Symptoms of a spontaneous pneumothorax usually begin suddenly and can range from mild to severe. Common signs include:

• Sharp, one-sided chest pain, often worse with deep breaths or coughing

• Shortness of breath, from mild discomfort to difficulty breathing even at rest

• Rapid breathing or a fast heart rate as the body tries to compensate

• Fatigue or lightheadedness due to reduced oxygen levels

• Bluish lips or nails in severe cases, which is a medical emergency

• Dry cough, sometimes triggered by irritation from the collapse

If sudden chest pain and shortness of breath occur, seek medical care immediately. A collapsed lung can become serious quickly and requires prompt evaluation in an emergency department.

Diagnosis

Diagnosis begins with a physical exam. A doctor listens for reduced or absent breath sounds on one side and may tap on the chest to check for a hollow sound that suggests trapped air.

The main diagnostic test is a chest X-ray, which quickly shows air in the pleural space and how much of the lung has collapsed. If the X-ray is unclear or the pneumothorax is very small, a CT scan may be used for a more detailed view. In emergency settings, ultrasound can also identify a pneumothorax quickly.

Doctors may check oxygen levels with a pulse oximeter or an arterial blood gas test to see how much the collapse is affecting breathing. Once confirmed, the medical team evaluates the size of the pneumothorax and determines the best treatment plan.

Treatment and Recovery

Treatment focuses on re-expanding the lung and removing trapped air.

• Observation: Small pneumothoraxes with mild symptoms may heal on their own. Oxygen and follow-up X-rays are used to ensure improvement.

• Needle Aspiration or Chest Tube: Larger collapses or significant symptoms often require removing air with a needle or a chest tube. The tube stays in place until the leak stops and the lung fully expands.

• Pleurodesis: If the pneumothorax recurs or the air leak continues, doctors may seal the pleural space with talc, medicine, or a blood patch to prevent future collapses.

• Surgery: Minimally invasive surgery (VATS) may remove or repair leaking blebs and is often combined with pleurodesis. Surgery greatly reduces recurrence.

Recovery

Most people recover fully. Small collapses heal within one to two weeks. Larger ones that require a chest tube or surgery take longer and usually involve a short hospital stay.

Avoid flying for one to two weeks and avoid scuba diving unless surgically treated. Quitting smoking is strongly recommended because it greatly lowers recurrence risk.

Follow-up visits and imaging confirm healing. Recurrence happens in about 10 to 30 percent of cases, but most people return to normal activities once the lung has re-expanded and symptoms resolve.