A collapsed lung, medically known as a pneumothorax, occurs when air leaks into the space between the lung and the chest wall. This air buildup creates pressure, causing the lung to partially or fully deflate and preventing it from expanding properly. A pneumothorax is a serious medical situation that requires prompt evaluation and care.
Understanding a Collapsed Lung
The lungs are encased within a double-layered membrane called the pleura, which forms a thin, fluid-filled space known as the pleural cavity. Normally, this space maintains a negative pressure, allowing the lungs to expand fully during breathing. When air escapes into this pleural space, it disrupts the pressure balance, leading to the lung’s inability to inflate.
This air leakage can stem from various causes. Traumatic injuries, such as a rib fracture or a penetrating chest wound, can puncture the lung and allow air to escape. A collapsed lung can also occur spontaneously, sometimes in tall, thin individuals or smokers, due to the rupture of small air sacs on the lung surface. Underlying lung conditions like chronic obstructive pulmonary disease (COPD), asthma, or cystic fibrosis can weaken lung tissue, making it more susceptible to collapse.
How a Collapsed Lung Sounds
When a healthcare professional examines a person with a suspected collapsed lung, listening to the chest with a stethoscope is a primary step. The most common auditory finding is a significant reduction or complete absence of normal breath sounds over the specific region where the lung has deflated. This occurs because the air trapped in the pleural space exerts pressure, preventing the lung from expanding and effectively moving air in and out. Unlike a healthy lung, which produces clear, soft, rustling sounds as air fills its structures, a collapsed lung will sound muffled or silent due to the lack of proper airflow.
The key diagnostic sign for a collapsed lung is the absence or diminishment of expected respiratory sounds. While other abnormal sounds, like crackles or wheezes, might be present in cases involving underlying lung disease, the primary indicator remains the lack of normal breathing sounds.
Other Important Symptoms and When to Seek Care
A person experiencing a collapsed lung often presents with noticeable symptoms. The experience is often one of profound breathlessness, an inability to inhale deeply, or a persistent feeling of chest tightness. These sensations result from the lung’s inability to inflate and efficiently exchange oxygen and carbon dioxide, leading to a sense of air hunger and discomfort.
A sudden, sharp chest pain is commonly reported, typically localized to one side of the chest and often worsening with deep breaths, coughing, or movement. This pain can sometimes radiate to the shoulder or back. Shortness of breath, medically termed dyspnea, is another frequent symptom, ranging from mild to severe depending on how much of the lung has collapsed. Rapid breathing (tachypnea) and a persistent dry cough may also accompany these sensations as the body struggles to get enough air.
In more severe instances of a collapsed lung, additional symptoms can manifest, indicating a more serious impact on the body’s oxygenation. A bluish tint to the skin or lips, known as cyanosis, can occur due to low oxygen levels in the blood. A rapid heart rate (tachycardia) may also be observed as the heart works harder to circulate oxygen. Seeking immediate emergency medical attention is important if a collapsed lung is suspected, regardless of the initial symptom severity.
What to Expect During Medical Assessment and Initial Treatment
Upon arrival at a medical facility, healthcare providers will conduct a physical examination, which includes listening to the chest for the diminished breath sounds characteristic of a collapsed lung. A chest X-ray is the primary diagnostic tool used to confirm the presence and size of the pneumothorax. In some cases, a CT scan or ultrasound may be used to provide more detailed images or assess for underlying causes.
Initial treatment for a collapsed lung varies depending on its size and the patient’s symptoms. For very small collapses with minimal symptoms, observation and supplemental oxygen therapy may be sufficient, allowing the lung to re-expand on its own. For larger or more symptomatic cases, procedures to remove the air from the pleural space are necessary. This can involve needle aspiration, where a needle draws out excess air, or the insertion of a chest tube (thoracostomy), a hollow tube placed between the ribs to continuously drain air and allow the lung to reinflate.