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A collapsed lung, medically termed pneumothorax, occurs when air escapes from the lung into the pleural space, the area between the lung and chest wall. This air accumulation exerts pressure on the lung, preventing it from fully expanding and leading to partial or complete collapse. This medical condition needs immediate treatment to prevent further complications. Scroll till the end to read more about this condition, including its causes, symptoms, diagnosis, and treatment.
Synopsis
What Causes Air Leaks in the Lung?
Air leaks can result from various factors, including:
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Spontaneous Pneumothorax: Occurs without an apparent cause. Primary spontaneous pneumothorax typically affects healthy individuals, often tall, thin males, while secondary spontaneous pneumothorax arises in those with underlying lung diseases like chronic obstructive pulmonary disease (COPD).
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Traumatic Pneumothorax: Results from blunt or penetrating chest injuries, such as those sustained in car accidents or stab wounds.
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Iatrogenic Pneumothorax: Caused by medical procedures, including lung biopsies, central line placements, or mechanical ventilation.
Recognising the Symptoms
Symptoms of a collapsed lung can vary based on the extent of the collapse and the individual's overall health. Common signs include:
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Sudden, sharp chest pain
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Rapid heart rate
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Fatigue
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Bluish skin colouration due to lack of oxygen (cyanosis)
In severe cases, especially with tension pneumothorax, symptoms can escalate to low blood pressure, severe respiratory distress, and loss of consciousness, necessitating immediate medical attention.
Factors that Worsen the Collapsed Lung Condition
1. Underlying Lung Diseases
Conditions like COPD (especially emphysema), pulmonary fibrosis (e.g., idiopathic or connective tissue‑associated ILD), asthma, cystic fibrosis, pneumonia, tuberculosis, and lung cancer weaken lung tissue, heightening the risk of leaks and poor recovery.
2. Mechanical ventilation & barotrauma
High airway pressures, especially peak inspiratory pressure ≥50 cm H₂O in mechanical ventilation, can rupture alveoli, causing pneumothorax. Tension pneumothorax is more common in ventilated patients and carries significantly higher mortality.
3. Tension pneumothorax
When a one-way valve effect lets air enter the chest cavity but not escape, intrapleural pressure builds, causing mediastinal shift, impaired blood return, hypotension, and respiratory collapse. This is life-threatening and must be treated immediately.
4. Low BMI, tall/lean body habitus, and connective tissue disorders
Tall, thin individuals, especially males, have an increased likelihood of bleb formation and spontaneous leaks. Low BMI independently predicts pneumothorax in both idiopathic and connective tissue-related ILD.
5. Smoking and inhaled drug use
Both tobacco and cannabis markedly raise the risk of primary spontaneous pneumothorax in heavy smokers and also impair healing, increasing recurrence.
6. Recurrent pneumothorax
With each episode, the risk of recurrence increases. Recurrences tend to be more frequent and complicated.
7. Procedural/traumatic causes
Latrogenic pneumothorax from procedures (biopsy, central line insertion, thoracentesis) tends to have better outcomes than those from barotrauma, but trauma-related ones (e.g., rib fractures, stab wounds) can result in larger leaks or open pneumothoraces with subcutaneous emphysema.
8. Concurrent sepsis or critical illness
In ICU patients, pneumothorax coupled with septic shock significantly increases mortality; barotrauma-induced pneumothorax, tension pneumothorax, and sepsis are independent predictors of death.
9. Rapid re‑expansion of the lung
Treating a long-standing pneumothorax too aggressively can trigger re-expansion pulmonary oedema, which adds respiratory risk.
10. Environmental pressures & occupational hazards
Activities like flying soon after pneumothorax, scuba diving, or exposure to high air pollution, especially post-COVID lockdown or at high altitude, can worsen existing blebs or trigger recurrence.
More Reads: 10 Common Symptoms of Lung Tumours You Must Know
Diagnostic Approaches
Healthcare providers employ several methods to diagnose pneumothorax:
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Physical Examination: Listening for diminished or absent breath sounds on the affected side.
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Imaging Tests: Chest X-rays are commonly used to detect air in the pleural space. In complex cases, a CT scan may provide more detailed images.
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Blood Tests: Assess oxygen and carbon dioxide levels in the blood.
An expert cardiothoracic surgeon in Manipal Hospitals Gurgaon will determine which diagnostic test is required to confirm the condition based on your symptoms and health record.
Treatment Options
The treatment strategy depends on the severity of the pneumothorax:
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Observation: Small pneumothoraces may resolve on their own with rest and oxygen therapy.
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Needle Aspiration or Chest Tube Insertion: For larger air leaks, a needle or chest tube may be inserted to remove the trapped air and allow the lung to re-expand.
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Surgery: In recurrent or persistent cases, surgical intervention may be necessary to repair the source of the air leak.
Preventive Measures
While not all pneumothoraces can be prevented, certain measures can reduce risk:
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Avoid Smoking: Smoking increases the risk of lung diseases that can lead to pneumothorax.
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Cautious Participation in High-Risk Activities: Activities like scuba diving or flying in unpressurized aircraft can pose risks, especially for individuals with a history of lung issues.
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Regular Medical Check-ups: For those with underlying lung conditions, routine monitoring can help detect and manage potential complications early.
Conclusion
Understanding the causes, symptoms, and treatment options for air leaks in the lungs is crucial for prompt diagnosis and effective management. If you experience sudden chest pain or difficulty breathing, seek medical attention immediately.
FAQ's
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Spontaneous bleb/bulla rupture (young, healthy individuals).
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Underlying lung conditions (e.g., asthma, pneumonia, COPD, TB).
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Chest trauma (e.g., accidents, stab wounds).
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Medical procedures (lung biopsies, central line insertion, mechanical ventilation).
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Smokers
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Patients with existing lung diseases.
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Those on mechanical ventilation.
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People with connective tissue disorders like Marfan syndrome.
It can be life-threatening if tension pneumothorax develops, which needs immediate emergency care. Even non-tension cases require prompt medical assessment.
Recovery typically takes a few days to two weeks for small cases; surgical intervention may require longer rest.
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Quit smoking; this is the most effective preventive measure.
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Avoid air pressure changes (e.g., flying too soon, scuba diving).
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Follow‑up imaging and consider pleurodesis in recurrent cases.
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