The relative negative pressure within the pleural cavity keeps the lung expanded. A pneumothorax develops when this negative pressure no longer exists. It leads to collapse of part or all of a lung. It is caused by free air in the chest between the two layers of the pleura (thin membranes that line the chest and the lung). It occurs more commonly in young men, but can occur at any age.
Causes of Pneumothorax
The most common cause of a spontaneous pneumothorax is the rupture of a bulla. A bulla is a dilated air sac that is on the surface of the lung. These occur most frequently in tall, thin young men. They may rupture from intense physical exercise or may rupture for no apparent reason. Other conditions that can lead to rupture of a small air sac in the lung include asthma, lung abscess and empyema (pus in the pleural cavity). Sometimes, diving or high altitude flying can produce a pneumothorax. Pneumothorax is commonly due to trauma. Penetrating wounds to the chest, which permit outside air to rush into the pleural space or lacerate the lung can cause pneumothorax. Thoracentesis, where a needle is placed into fluid which has collected outside of the lung, can lead to a pneumothorax.
Signs and Symptoms of Pneumothorax
The following symptoms vary according to the degree of lung collapse and extent of underlying lung diseases and may be less acute if the pneumothorax develops slowly. There is sharp chest pain, with extension of the pain to the shoulder, neck or abdomen. Shortness of breath may be mild or severe. A dry, hacking cough may develop. Occasionally, the air within the pleural cavity will progressively increase leading to a tension pneumothorax. Here, the pressure gets so high that it compresses the other lung and impairs blood return to the heart. Lightheadedness, loss of consciousness and death may occur.
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Medical Content Last Updated on 07/12/2008
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