What are the common symptoms of pneumothorax? How to determine if pneumothorax has occurred?

The typical symptoms of pneumothorax are sudden chest pain, chest tightness and difficulty breathing. The severity of the symptoms depends on the speed of onset, the amount of pneumothorax and the underlying lung disease. It is usually caused by severe coughing or exercise. So what are the common symptoms of pneumothorax? How to determine if pneumothorax has occurred?

What are the symptoms of pneumothorax?

1. Chest pain is the earliest symptom in patients with pneumothorax. Most cases are sudden, severe or tearing pains that are aggravated by breathing, coughing, or chest and upper limb activities. The pain is most obvious where the lesion is located.

2. Chest tightness, shortness of breath, and difficulty breathing usually occur after chest pain. Mild cases manifest as chest tightness and shortness of breath, which gradually worsen. In severe cases, obvious breathing difficulties, hair loss, etc. may occur rapidly, and even shock, respiratory failure, heart failure and death may occur.

3. Cough, mostly irritating dry cough.

4. Shock. Shock is not common in patients with pneumothorax and is generally seen in tension pneumothorax. It is caused by severe pressure and dysfunction of the heart and lungs. The clinical manifestations include severe dyspnea, cyanosis, cold sweat, rapid and weak pulse, decreased blood pressure, decreased urine volume or even anuria, cold and wet limbs, etc., which may lead to death due to circulatory and respiratory failure.

5. Pleural air accumulation. In patients with pneumothorax, the pleural air accumulation is usually not obvious. If the pleural air accumulation increases, the chest cavity on the affected side will be full, the respiratory movement will be weakened, the percussion will be excessively resonant or tympanic, and the trill and breath sounds will be reduced or disappear. When a large amount of air accumulates, the trachea and heart move to the opposite side. In right-sided pneumothorax, the liver dullness boundary decreases, and in left-sided pneumothorax, the cardiac dullness boundary disappears.

What tests should patients with pneumothorax undergo?

1. Chest X-ray is the most reliable method for diagnosing pneumothorax. It can show the degree of lung compression, lung condition, presence or absence of pleural adhesion, pleural effusion, and mediastinal shift, etc.

2. Based on the chest X-ray, the degree of lung compression and collapse after pneumothorax can be roughly calculated, which is of certain significance for clinical treatment.

3. Chest CT examination: The basic CT manifestation of pneumothorax is the appearance of extremely low-density gas shadows in the pleural cavity, accompanied by varying degrees of compression and atrophy of lung tissue. Generally, observation should be made under the condition of a low window position lung window. The diagnosis of pneumothorax containing very small amounts of gas and localized pneumothorax mainly located in the anterior and middle pleural cavity may be missed on plain X-ray films, but there is no disadvantage of image overlap on CT, so the diagnosis is very easy. CT can also differentiate pneumothorax located beside the mediastinum from mediastinal emphysema and pulmonary air sacs. For patients with extensive subcutaneous emphysema, CT examination can often reveal the presence of pneumothorax that is negative on plain x-ray films. For patients with milder lung compression, the presence of obvious bullae can also be observed.