Pneumothorax (Collapsed Lung): Symptoms, Causes, and Emergency Care

Pneumothorax, also known as a collapsed lung, happens when air leaks into the space between the lung and chest wall, causing the lung to collapse. It can range from mild to life-threatening, especially in cases of tension pneumothorax where pressure builds up and compresses the heart. Seek immediate medical attention for sudden sharp chest pain or difficulty breathing.

In plain words

Pneumothorax, also called a collapsed lung, happens when air leaks into the space between the lung and chest wall. This makes the lung collapse. It can be mild or severe. A severe type called tension pneumothorax is dangerous because pressure builds up and presses on the heart. If you feel sudden sharp chest pain or have trouble breathing, get medical help right away.

What is Pneumothorax (Collapsed Lung): Symptoms, Causes, and Emergency Care?

Symptoms

Early symptoms

Sudden sharp chest pain: Pain typically localized to one side, often described as sharp or stabbing, and worsens with breathing or coughing. (1) (3) (4)
Shortness of breath: Difficulty breathing that may develop suddenly, often accompanied by chest pain. (1) (3) (4)
Mild discomfort: Some small pneumothoraces may cause only mild discomfort or no noticeable symptoms at first. (4)
Symptoms during rest or sleep: Spontaneous pneumothorax symptoms may develop during rest or sleep, even without physical exertion. (4)

Serious or emergency symptoms

Rapid heart rate: Heart rate exceeding 140 beats per minute, indicating severe stress on the cardiovascular system. Seek emergency care immediately. (6) (4)
Blue-tinged skin or lips (cyanosis): A sign of severe oxygen deprivation, indicating a critical situation. Call emergency services immediately. (6) (4)
Extreme difficulty breathing: Severe respiratory distress, often accompanied by confusion or loss of consciousness. Seek emergency care right away. (6) (4)
Tracheal deviation and distended neck veins: Signs of tension pneumothorax, a life-threatening emergency where pressure in the chest compresses the heart and blood vessels. Call 911 or your local emergency number immediately. (6)

Causes

Primary causes

Spontaneous pneumothorax: Occurs without trauma, often from ruptured small air sacs (blebs) on the lung surface. (3) (4)
Traumatic pneumothorax: Caused by chest injuries, medical procedures, or rib fractures. (3)
Secondary pneumothorax: Occurs in people with underlying lung diseases like COPD or cystic fibrosis. (3) (4)
High-altitude activities and scuba diving: These activities can trigger pneumothorax in susceptible individuals. (4)

Risk factors

Being tall and thin

Tall, thin young males are more prone to spontaneous pneumothorax. (4)

Smoking

Smoking increases the risk of pneumothorax, especially spontaneous types. (4)

Pre-existing lung conditions

Conditions like COPD, cystic fibrosis, or asthma increase the risk. (4)

Family history

A family history of pneumothorax can increase risk. (4)

Diagnosis

Pneumothorax is typically diagnosed through chest X-rays, which show the lung edge separated from the chest wall. CT scans may be used for complex cases. Emergency physicians often use bedside ultrasound for rapid diagnosis in critical cases. Oxygen levels and breath sounds are also checked to confirm the diagnosis.

Chest X-ray

First-line imaging to show lung edge separation from the chest wall. (3) (5) (6)

CT scan

Used for complex cases where X-ray results are unclear. (5)

Bedside ultrasound

Rapid diagnostic tool used in emergency settings to confirm pneumothorax. (6)

Oxygen level check

Determines the extent of oxygen deprivation caused by the collapsed lung. (5)

Treatment

Medication options

Supplemental oxygen

Helps re-expand the lung by increasing oxygen levels in the bloodstream. (2) (5)

Needle aspiration

Removes air from the pleural space using a needle, allowing the lung to re-expand. (2) (5)

Chest tube insertion

Continuously removes air from the pleural space, allowing the lung to re-expand over time. (2) (5)

Lifestyle and self-care

Observation and rest: Small pneumothoraces may resolve without invasive treatment, but require close monitoring and follow-up imaging. (2) (5)
Avoid strenuous activity: Restricting physical activity helps prevent worsening of the pneumothorax during recovery. (2)
Smoking cessation: Quitting smoking reduces the risk of recurrence, especially in spontaneous pneumothorax. (4)
Follow-up medical care: Regular follow-up visits and imaging are essential to ensure the lung has fully re-expanded. (2) (5)

Always discuss dosing and treatment changes with your own prescriber.

Possible complications

Recurrent pneumothorax: Patients with one pneumothorax have a higher risk of recurrence, especially smokers. (4)
Tension pneumothorax: A life-threatening condition where pressure in the pleural space compresses the heart and lungs. (6)
Respiratory failure: Severe pneumothorax can lead to complete respiratory collapse if not treated promptly. (4)
Secondary infections: Invasive procedures like chest tube insertion carry a risk of infection. (2)

When to see a doctor

Routine follow-up

Seek medical evaluation for persistent chest pain or mild shortness of breath, especially if symptoms worsen with breathing. (1) (5)

Seek emergency care

Call 911 or your local emergency number immediately if you experience severe chest pain, rapid heart rate, difficulty breathing, or blue-tinged skin/lips. (6) (4)
Seek emergency care for signs of tension pneumothorax, including tracheal deviation, distended neck veins, or confusion. (6)

Frequently asked questions

Is pneumothorax life-threatening?

Tension pneumothorax is a life-threatening emergency that requires immediate treatment. While small pneumothoraces may resolve on their own, severe cases can be fatal without prompt medical care. (1) (3)

Can pneumothorax heal without treatment?

Small pneumothoraces may heal with observation and oxygen therapy alone, but all cases require medical evaluation to confirm lung re-expansion and rule out complications. (5)

What causes pneumothorax to happen suddenly?

Spontaneous pneumothorax often occurs without warning when small air sacs (blebs) on the lung surface rupture. It is more common in tall, thin males aged 20-40, especially smokers. (3) (4)

How is pneumothorax different from a heart attack?

Pneumothorax pain is typically sharp and localized to one side, worsening with breathing. Heart attack pain often feels like pressure or squeezing in the center chest, possibly radiating to the arm/jaw. (1) (3)

Can pneumothorax happen more than once?

Yes, recurrence rates are high after a first episode. Surgical options like pleurodesis may be recommended to reduce recurrence risk after repeated collapses. (4) (5)