A tension pneumothorax is a complete collapse of the lung. It occurs when air enters, but does not leave, the space around the lung (pleural space).

See also: Pneumothorax

Pneumothorax - tension

Any condition that leads to pneumothorax can cause a tension pneumothorax. In uncomplicated pneumothorax, air can enter and leave the pleural space easily. In tension pneumothorax, however, air enters the pleural space with each breath and gets trapped there.

As the amount of trapped air increases, pressure builds up in the chest. The lung collapses on that side and can push the important structures in the center of the chest (such as the heart, major blood vessels, and airways) toward the other side of the chest. The shift can cause the other lung to become compressed, and can affect the flow of blood returning to the heart.

This situation can lead to low blood pressure, shock, and death.

• Sudden chest pain
• Shortness of breath
• Chest tightness
• Easy fatigue
• Bluish color of the skin due to lack of oxygen
• Rapid heart rate
• Low blood pressure
• Decreased mental alertness
• Decreased consciousness
• Rapid breathing
• Bulging (distended) veins in the neck

When heard through a stethoscope, the breath sounds are decreased. Structures in the center of the chest (mediastinum) may appear to have moved. There may be air trapped in the tissue of the chest wall (subcutaneous emphysema), causing a spongy feeling when the chest is felt with the hands (palpation).

In general, if a health care provider suspects tension pneumothorax, treatment should start before tests are done. Some tests can help confirm the diagnosis and determine the severity of the problem.

Tests used to diagnose tension pneumothorax include:

• A chest x-ray
• Arterial blood gases
• Electrocardiogram