Understanding pneumothorax: Causes, symptoms, and treatment

Written in association with: Mr Marco Scarci
Published:
Edited by: Kate Forristal

Repairing a collapsed lung often involves thoracoscopy, a minimally invasive procedure with small incisions, a miniature camera (endoscope), and surgical instruments. In his latest online article, Mr Marco Scarci explores the causes, symptoms, and treatment options for pneumothorax.

What is the primary cause of pneumothorax?

Pneumothorax is frequently a result of a puncture or tear in the lung tissue, typically caused by chest trauma. Other contributing factors may include medical procedures like thoracentesis (removing excess fluid from the pleural cavity) or mechanical ventilation. Underlying medical conditions such as chronic obstructive pulmonary disease (COPD), cystic fibrosis, or lung cancer can also elevate the risk of pneumothorax.

 

In some cases, pinpointing the cause of pneumothorax is challenging, particularly in young, tall, and slender individuals, which is termed idiopathic pneumothorax.

 

What are the three indicators of a pneumothorax?

  1. Sudden and intense chest pain on one side that may exacerbate with deep breathing or coughing.
  2. Shortness of breath that may intensify as the pneumothorax advances.
  3. Elevated heart rate and low blood pressure if the pneumothorax is sizable enough to compress the heart or major blood vessels.

 

How severe is a pneumothorax?

Pneumothorax, also known as a collapsed lung, can be a serious condition depending on its extent and underlying cause. It occurs when air infiltrates the space between the lung and chest wall, leading to lung collapse.

 

If left untreated or in the presence of a large pneumothorax, it can result in significant breathing difficulties, chest pain, and potentially death. However, a minor pneumothorax may be asymptomatic and could resolve on its own.

 

Treatment options vary based on pneumothorax size and underlying causes and may include observation, oxygen therapy, needle aspiration, or chest tube insertion. Seeking medical attention is crucial if pneumothorax is suspected or if troubling symptoms arise.

 

How is pneumothorax treated?

The treatment for pneumothorax depends on its severity and whether it is primary or secondary.

 

For primary pneumothorax (without underlying lung disease), treatment may involve:

  • Observation if the pneumothorax is small and asymptomatic.
  • Oxygen therapy to facilitate reabsorption of trapped air in the lung tissue.
  • Aspiration, where a needle is used to remove trapped air.
  • Chest tube insertion, involving a flexible tube placed in the pleural space to evacuate air and allow lung re-expansion.

 

For secondary pneumothorax (resulting from lung disease), treatment may encompass: 

  • Diagnosis and treatment of the underlying condition (e.g., pneumonia, COPD, lung cancer). 
  • Oxygen therapy.
  • Chest tube insertion.
  • Surgery, if necessary, to prevent recurrent pneumothorax episodes.

 

Immediate medical attention is essential if pneumothorax is suspected, as it can be life-threatening if untreated.

 

Does pneumothorax occur suddenly?

In numerous cases, pneumothorax can manifest suddenly without prior warning signs or symptoms. Common indicators include abrupt chest pain worsening with breathing or coughing, shortness of breath, rapid heart rate, or a sensation of chest tightness. If there is suspicion of pneumothorax or any other medical emergency, seeking immediate medical attention is imperative.

 

Mr Marco Scarci is an esteemed consultant thoracic surgeon with over 20 years of experience. You can schedule an appointment with Mr Scarci on his Top Doctors profile.

By Mr Marco Scarci
Cardiothoracic surgery

Mr Marco Scarci is a highly respected consultant thoracic surgeon based in London. He is renowned for his expertise in keyhole surgery, particularly in the treatment of lung cancer and pneumothorax (collapsed lung). He also specialises in rib fractures, hyperhidrosis (excessive sweating), chest wall deformities and emphysema. He sees private patients at OneWelbeck, the Harley Street Clinic and the Sainsbury Wing, Imperial Private Healthcare.
 
Mr Scarci qualified as a doctor of medicine with honours in 2001 at Italy’s Università degli Studi 'Gabriele d'Annunzio' di Chieti, before pursuing further specialist training in cardiothoracic surgery. He then undertook a clinical fellowship at Basildon and Thurrock University Hospital and a senior clinical fellowship in thoracic surgery at Guy’s and St. Thomas’ NHS Foundation Trust. In addition, he completed an additional six-month thoracic surgery fellowship at the University of Toronto, Canada in 2011 and another in advanced keyhole surgery with McMaster University, Canada. That same year, he was appointed as a consultant thoracic surgeon at Papworth Hospital NHS Foundation Trust. Following this, he went on to work at University College London Hospital, San Gerardo Hospital, Italy and Imperial College NHS Healthcare Trust, where he is currently based. With his wealth of experience and expertise in both surgical and non-surgical treatment for a wide range of conditions, Mr Scarci is regarded as one of the UK’s leading practitioners in the field of thoracic surgery, whose skill and dedication has been recognised with several awards, including an NHS Clinical Excellence award in 2013.
 
Throughout his esteemed career, Mr Scarci has held a number of senior positions. He previously led chest wall database and pleural malignancies working groups for the European Society of Thoracic Surgeons and was also formerly a council member and director of the Society's annual conference, the largest conference in thoracic surgery in the world. He also forms part of several of the National Institute for Health and Care Excellence’s (NICE) working groups. Mr Scarci is also a leading name in medical education and is an honorary clinical senior lecturer at Imperial College London and a senior clinical tutor at the University of Cambridge.
 
Mr Scarci has an extensive background in academic research and has authored over one hundred and thirty publications which appear in leading peer-reviewed journals. With his wealth of expertise, he is a co-speciality chief editor for thoracic surgery in the revered Frontiers in Surgery academic journal and is an associate editor of the Journal of Thoracic Disease and the Journal of Thoracic and Cardiovascular Surgery, the most prestigious in his speciality. He is also the author and editor of four published books on minimally invasive and open thoracic surgery.
 
Mr Scarci regularly presents at key conferences in the field of thoracic surgery. He is an appointed fellow of a number of highly respected professional bodies, including the Royal College of Surgeons of England, the American College of Chest Physicians, the American College of Surgeons and the European Board of Cardiothoracic Surgery. With support from his administrative team, patients can get in contact with Mr Scarci quickly and efficiently. Mr Scarci is dedicated to providing attentive, friendly, and reassuring care for his patients that is tailored to their individual needs in order to improve their quality of life.

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