American Medical Association Family Medical Guide - American Medical Association [392]
Symptoms
The major symptoms of pneumothorax are breathlessness, pain in the chest, and sometimes pain at the side of the neck adjacent to the shoulder. The pain occurs suddenly and is usually sharp, or it may only be uncomfortable.
The severity of the symptoms depends on the degree to which the lung has collapsed and on your health. If you are young and in good health, you may have only slight pain and little difficulty breathing, even if a large portion of your lung has collapsed. If you are older and have a lung disorder such as emphysema, even a small, partial lung collapse can be very painful and cause extreme difficulty breathing.
Collapsed lung
If air is present in the pleural space, it can push into the adjoining lung, reducing the lung’s ability to expand as you breathe air in.
Diagnosis
If you have symptoms of pneumothorax, your doctor will examine you to see if the affected side of your chest moves less than the unaffected side when you breathe, and tap your chest with his or her fingers to listen to (and interpret) the sounds produced by the tapping. If your doctor thinks you have pneumothorax, he or she will probably admit you to the hospital for observation. He or she also will recommend diagnostic tests such as a chest X-ray and lung function tests (see page 647).
Treatment
Treatment for pneumothorax depends on the amount of air in the chest, the extent of the lung collapse, and the condition of the lungs. A small pneumothorax often heals on its own. In rare cases, a doctor may recommend hospitalization to treat a collapsed lung. After administering a local anesthetic into the chest, the doctor may use a needle and syringe to suck the air out of the chest cavity, allowing the lung to reinflate. If the collapsed portion of the lung is large, the doctor may remove the air with a flexible tube (catheter) inserted through the chest into the pleural space. Or a doctor may inject a substance into the area of the leak to cause inflammation and make the two pleural membranes fuse, sealing the leak and allowing the membranes to heal.
If the pneumothorax persists, a doctor will recommend surgery to permanently close the leak. The surgeon may scrape the affected area of the lung, producing an effect similar to that of injecting the inflammatory substance, making the membranes stick together as they heal.
Occupational Lung Diseases
You may be exposed to poisonous substances in the form of gases, vapors, fumes, particles, or powders while on the job, whether you work in an office or factory or on a farm. Many of these substances can damage the respiratory tract or cause lung diseases. The sources of some occupational lung diseases (such as inhaling a toxic gas that instantly makes breathing difficult) are obvious. Other causes, such as exposure to asbestos (an insulating building material) or coal dust, can take 10 to 25 years to cause disease. Pneumoconiosis (dust lung) is the name for lung diseases that occur from long-term exposure to metallic or mineral dusts such as asbestos (asbestosis), beryllium (berylliosis), coal (coal miners’ lung, also called black lung disease), and silica (silicosis).
If your lungs are repeatedly exposed to harmful substances, the chronic inflammation can lead to permanent scarring of lung tissue and potentially fatal respiratory failure (see right) and congestive heart failure (see page 570). Exposure to some substances increases