Collapsed Lung: Why It Happens & How It’s Treated
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What is a collapsed lung?
A collapsed lung, also called a pneumothorax, occurs when air enters the area between the lung and the chest wall, known as the pleural space. This can happen if there is a hole in the lung or in the chest wall. It’s usually caused by an injury, like a car accident or gunshot wound, but can also occur in people with lung disease or heavy smokers. The trapped air makes it impossible for your lung to inflate normally.
A collapsed lung can affect a small or large area of the lung. Symptoms include chest pain, difficulty breathing, or an elevated heart rate. It’s important to seek prompt medical treatment if you suspect a collapsed lung, since it can place additional pressure on your lungs, heart, and/or vessels in your chest cavity.
How do you know if your lung has collapsed?
Be aware of the signs and symptoms of a pneumothorax so that you can seek the appropriate care. —Dr. Chandra Manuelpillai
The most common symptoms include sudden difficulty breathing and chest pain. The pain may be sharper when you breathe in, a pain known as “pleuritic.”
- Sudden difficulty breathing
- Sudden pleuritic chest pain
Other symptoms you may have
- Increased heart rate
- Increased rate of breathing
What causes lungs to collapse?
A traumatic injury can cause lungs to collapse. In a gunshot wound or stabbing, a hole in the chest wall causes air to leak. If you hit your chest, such as on the steering wheel in a car accident, your lung can “pop” and air can begin to leak.
In other cases, a collapsed lung occurs for no apparent external reason. Damaged lung tissue is more likely to collapse, so you may be at risk of a collapsed lung if you have underlying lung disease such as cystic fibrosis and chronic obstructive pulmonary disease (COPD) or if you smoke (tobacco cigarettes, cigars, marijuana, or vaping).
A collapsed lung can also occur when small air blisters, called blebs, that develop on the top of your lungs burst. This is more common in men than women, and most likely to occur in males between 20 and 40 years old who are tall and underweight.
Collapsed lungs may also run in families. Once you have one collapsed lung, you are at an increased risk of having another one, sometimes within 1-2 years of the first. People who have had a collapsed lung in the past may need to be careful about activities that cause air pressure changes, like scuba diving or flying in an unpressurized aircraft.
What to do if you think you have a collapsed lung
A pneumothorax can be life threatening. If the collapsed lung is large enough, it can cause pressure on the other lung, heart and chest cavity vessels, which can lead to death. Get a diagnosis as soon as possible. —Dr. Manuelpillai
A collapsed lung is treatable, but can be life-threatening. You should go directly to an emergency department or call 911, particularly if you are having chest pain, difficulty breathing, and heart racing. The symptoms of a collapsed lung may be similar to other serious medical emergencies, such as a heart attack, blood clot in the lungs (pulmonary embolism), and an abnormal heart rhythm.
Minor lung injuries are treated with observation and oxygen. More extensive injuries require a tube to be placed within your chest cavity, which allows air to flow out and allows your lungs to inflate.
Collapsed lung in children
Pneumothoraces are uncommon in children. However, they may occur in newborns within the first few days of life. Premature babies are more at risk since their lungs may not be fully developed and therefore more likely to get injured and cause an air leak. Children with lung disease are at greater risk of a collapsed lung. Children with a collapsed lung also experience difficulty breathing and chest pain. It may be difficult to know if a younger child has a collapsed lung since babies and toddlers are less able to voice their symptoms. Signs of a collapsed lung in babies and toddlers include blue lips, rapid breathing, and chest retraction. This is when the skin sinks between the ribs.
Treatment is similar to treatment in adults.
Collapsed lung treatment
It is always essential to get prompt medical treatment for a suspected collapsed lung. But if the injury is small, your doctor may administer oxygen. They will use X-Rays and observation to assess how your lung is healing, and you may be discharged the same day. If the injury is minor, you may be discharged from the hospital and told to rest to heal the lung. This could be a few weeks of limiting activities.
But if the injury is larger, the pressure difference from the air leak needs to be corrected to allow the lung to reinflate. This is done by inserting a needle or tube between the ribs to allow the air trapped between the inner chest wall and outer lungs to be removed. As the air is removed from that space, the lung is able to reinflate. You will need to be admitted to the hospital for observation.
If it appears to be healing, the tube will be removed and you will be discharged home. If it’s not improving, you may need another procedure or surgery to close the air leak.
If you require a chest tube, you may need to follow up with a specialist like a critical care specialist, pulmonologist, or cardiothoracic surgeon.
Unfortunately, there is no definitive way to prevent a pneumothorax since they can occur spontaneously or due to trauma.
However, you can decrease your risk by not smoking or vaping. People who have had a collapsed lung in the past may need to be careful about activities that cause air pressure changes, like scuba diving or flying in an unpressurized aircraft. These can cause a repeat pneumothorax.
Once you have had a pneumothorax, you are at an increased risk of developing another one. Discuss with your doctor the possible causes of your pneumothorax and ways to avoid recurrence such as quitting smoking, as well as possible activities to avoid like scuba diving. —Dr. Manuelpillai
Dr. Manuelpillai is a board-certified Emergency Medicine physician. She received her undergraduate degree in Health Science Studies from Quinnipiac University (2002). She then went on to graduated from Rosalind Franklin University of Medicine and Sciences/The Chicago Medical School (2007) where she served on the Executive Student Council, as well as was the alternate delegate to the AMA/ISMS-MSS Governing Council and the student representative to the Illinois State Medical Society (ISMS) Education and Health Workforce committee. She completed an internship year with UCLA-Harbor Medical Center's Department of Internal Medicine followed by an emergency medicine residency program at Boston Medical Center (2011) while also serving as the resident representative to the Massachusetts Medical Society (MMS) committee on Student Health & Sports Medicine. She then started working at Saints Medical Center (later Lowell General Hospital/Saints Campus and Main Campus) in Lowell Massachusetts where she served as the Continuous Quality Improvement Director for the emergency medicine group, as well as was the representative for the emergency department on the Sepsis, Stroke and PCI Quality Assurance and Compliance Committees. She joined Buoy Health in 2019. She currently works in multiple emergency departments both in the community and academics, as well as previously worked in multiple urgent care centers. She believes this mix of experiences has given her a unique perspective on the care of acute illnesses.