Pneumothorax is a collapsing of the lung due to air pressure. This condition results when air leaks from the lungs and goes between the lung tissue and the chest wall, creating a buildup of pressure. A pneumothorax can be primary or spontaneous without any known cause, secondary or complicated, or from injury or disease. Another is a tension pneumothorax, a serious complication resulting from the first two types. The three main factors that confirm a pneumothorax diagnosis include the absence of breath sounds, characteristic X-ray appearance, and air aspiration.
Certain symptoms are the initial indicators that a pneumothorax may be present. Sudden, sharp, and tight chest pain, shortness of breath, and a persistent cough are all symptoms. The patient often has a blueish tint to the skin due to an inability to take in enough oxygen, and this is also reflected by rapid breathing and an increased heart rate. A doctor will take a patient's physical history, including whether he or she has suffered recent injury, has an underlying illness such as emphysema, or even if he or she smokes as these are all contributing factors. If a doctors suspects a pneumothorax, then he or she will conduct further tests to determine if certain factors that confirm the condition are present.
To confirm a pneumothorax diagnosis, doctors use a stethoscope to examine the patient. If the condition is present, they can diagnose it by noticing significantly decreased or absent sounds of breathing. This results from the lungs no longer being able to expand and contract properly to take in or expel air. Tapping with a finger on the patient's chest will also produce a hollow sound rather than the normal, solid sound. Finally, the sounds produced by both the trachea and the heart will have shifted to one side.
An X-ray can further confirm a pneumothorax diagnosis. This is usually a standing chest X-ray performed front to back to get the best picture. Pneumothorax can be confirmed by the characteristic appearance of an abnormal dark area on the film between the lung and the chest wall. This dark area is the resulting pocket of air that has leaked from the lungs and is causing the lung to compress. An X-ray can also confirm a pneumothorax diagnosis by showing the displacement of the heart and trachea to one side.
A tension pneumothorax diagnosis may have to be obtained another way due to the patient not being well enough to withstand a standing X-ray. Confirmation is often obtained from the insertion of a large bore needle into the space between the chest wall and the lung. If a large amount of air can be removed, then a pneumothorax diagnosis is confirmed.