How to identify pneumothorax and how to treat

Pneumothorax arises when air, which should have been inside the lung, is able to escape into the pleural space between the lungs and the chest wall. When this happens, the air puts pressure on the lung, causing it to collapse, and, for this reason, it is common to experience intense difficulty in breathing, chest pain and cough.

Pneumothorax usually arises after trauma, especially when there is a cut in the chest cavity or after a traffic accident, but it can also arise as a result of chronic illness or even <without any apparent cause, although it is more rare.

As it can severely affect breathing and even alter the functioning of the heart, whenever pneumothorax is suspected, it is very important to immediately go to the hospital to confirm the diagnosis and start the appropriate treatment, avoiding complications.

Main symptoms

The most common symptoms of pneumothorax include:

• Severe and sudden pain, which worsens when inhaling; Feeling of shortness of breath; Difficulty breathing; Bluish skin, especially on the fingers and lips; Increased heartbeat; Constant cough.

Initially, symptoms may be more difficult to identify and, therefore, it is common for pneumothorax to be identified only at a more advanced stage.

These symptoms can also be present in other respiratory problems and, therefore, should always be evaluated by a pulmonologist.

How to confirm the diagnosis

In most cases, the pneumothorax can be identified by a chest X-ray and symptom assessment, however, the doctor may also order other complementary tests, such as computed tomography or ultrasound, to identify more details that help to adapt the treatment.

What causes pneumothorax

There are several causes that can trigger a pneumothorax. Thus, according to the cause, pneumothorax can be divided into four main types:

1. Primary pneumothorax

It occurs in people without a history of lung disease and without any other apparent cause, being more common in smokers and in people with other cases of pneumothorax in the family.

In addition, tall people or between the ages of 15 and 34 also appear to be more likely to develop this type of pneumothorax.

2. Secondary pneumothorax

Secondary pneumothorax occurs as a complication of another disease, usually a previous respiratory problem. The most common types of lung disease as the cause of pneumothorax include COPD, cystic fibrosis, severe asthma, lung infections and pulmonary fibrosis.

Other diseases that can also result in pneumothorax, but which are not directly related to the lung are rheumatoid arthritis, systemic sclerosis or dermatomyositis, for example.

3. Traumatic pneumothorax

It is possibly the most common type of pneumothorax that occurs when trauma occurs in the thoracic region, due to deep cuts, rib fractures or traffic accidents, for example.

In addition, people who do diving may also have this type of pneumothorax, especially if they rise very quickly to the surface, due to pressure differences.

4. Hypertensive pneumothorax

This is one of the most serious forms of pneumothorax, in which air passes from the lung to the pleural space and cannot return to the lung, gradually accumulating and causing intense pressure on the lung.

In this type, it is possible that the symptoms worsen very quickly, being urgent to go to the hospital to start the treatment.

How the treatment is done

The main objective of the treatment is to remove the excess air that is accumulated, to relieve the pressure on the lung and allow it to expand again. For this, air is usually aspirated with a needle inserted between the ribs so that air can escape from the body.

After that, the person needs to be under observation to assess whether the pneumothorax reappears, doing regular examinations. If it reappears, it may be necessary to have surgery to place a tube that constantly draws air or to correct any changes in the lung that are causing air to accumulate in the pleural space.

In addition, it is also important to identify the correct cause of pneumothorax to find out if any more specific treatment is needed for the cause, in order to prevent the pneumothorax from recurring.