How to check for pneumothorax? Common methods of checking for pneumothorax

Pneumothorax is a common cardiothoracic disease, which refers to the rupture of the visceral pleura in the absence of trauma or human factors. Pneumothorax can cause great harm to the human body, such as causing pyopneumothorax, hemothorax, chronic pneumothorax, etc., which endangers the health of the heart and chest. So how can pneumothorax be detected?

1: Dyspnea. Patients will experience dyspnea during pneumothorax attacks. The severity of dyspnea is related to the course of the attack, the degree of lung compression and the original lung function status. Young patients with normal respiratory function may not have obvious dyspnea. Even if the lungs are compressed by 80%, they can only feel slight chest tightness during activities. However, elderly patients with chronic obstructive pulmonary emphysema may have obvious dyspnea even if the lungs are slightly compressed. In acute pneumothorax, the symptoms may be more obvious, while in chronic pneumothorax, the healthy lung can compensatory expand and the clinical symptoms may be milder.

2: Irritating cough Spontaneous pneumothorax occasionally causes an irritating cough.

3: Chest pain often occurs suddenly when pneumothorax occurs, with sharp stabbing and cutting pain. It has nothing to do with the sudden rupture of the bullae and the degree of lung compression, but may be related to increased pressure in the pleural cavity and stretching of the parietal pleura. The location of pain is uncertain and may be confined to the chest, or it may radiate to the shoulders, back, and upper abdomen. When significant mediastinal emphysema is present, persistent retrosternal pain may occur. Pain is the most common complaint of patients with pneumothorax and, in mild cases, may be the only symptom.

4: Other symptoms When pneumothorax is combined with hemothorax, if the amount of bleeding is heavy, the patient will experience palpitations, low blood pressure, cold limbs, etc.

1: Physical examination reveals small or localized pneumothorax with no positive signs. In typical cases, the trachea is displaced to the healthy side, the chest of the affected side is full, the respiratory movement is weakened, the percussion sound is too clear, and the breath sounds are weakened or disappeared. In patients with left-sided pneumothorax and concurrent mediastinal emphysema, a creaky sound (Hamman's sign) consistent with the heartbeat may sometimes be heard in the precordial area.

2: Auxiliary examinations (1) X-ray chest examination: It is the most reliable diagnostic method and can determine the degree of pneumothorax, lung compression, and the presence of complications such as mediastinal emphysema and pleural effusion. (2) Other examinations: ① Blood gas analysis: hypoxemia may occur in patients with lung compression >20%. ②Thoracentesis and pressure measurement can help determine the type of pneumothorax. ③Thoracoscopic examination: For chronic and recurrent pneumothorax, it helps to clarify the lung surface and pleural lesions. ④Hematological examination: No positive findings when there are no complications.

3: Differential diagnosis should be made from acute myocardial infarction, subpleural bullae, lung cysts, bronchial cysts, diaphragmatic hernia, etc.

A pathological and physiological condition caused by the rupture of the visceral pleura and the entry of gas into the pleural cavity, resulting in pleural gas accumulation. Pneumothorax caused by the rupture of subpleural emphysematous bubbles without obvious lung lesions is called idiopathic pneumothorax; pneumothorax secondary to pleural and lung diseases such as chronic obstructive pulmonary disease, pulmonary tuberculosis, etc. is called secondary pneumothorax. According to the pathological and physiological changes, it can be divided into three categories: closed (simple), open (communicating) and tension (high-pressure).