Pneumothorax

A pneumothorax is when air leaks into the space between one of your lungs and your chest wall. This space is called the 'pleural space'.

A pneumothorax can cause a 'collapsed lung'. This is when the air in your pleural space pushes on your lung. In most cases, only some of the lung collapses.

A tension pneumothorax is when there is increasing pressure in the air around your lung. It causes your heart and lungs to stop working properly. It's a medical emergency.

If you have trouble breathing or have chest pain, call triple zero (000) for an ambulance.

The most common symptoms of a pneumothorax are:

• sudden, sharp stabbing pain on one side of the chest, made worse by breathing in
• breathing problems — shortness of breath
• cough

Symptoms and signs of a tension pneumothorax can include:

• severe distress
• fast heart rate
• difficulty breathing
• fast and shallow breathing
• cyanosis (blueish lips and skin)
• sweating
• low blood pressure

There are different types and causes of pneumothorax.

Spontaneous pneumothorax

A spontaneous pneumothorax happens suddenly without an external event (such as trauma or a medical procedure).

A primary spontaneous pneumothorax is the most common type of pneumothorax. It usually happens in young people (including children) with no underlying lung disease.

It's not known what causes primary spontaneous pneumothorax, but the risk is higher for people who smoke. It's also more common in males who are tall and slim.

A secondary spontaneous pneumothorax can happen in people with existing lung conditions, such as:

• chronic obstructive pulmonary disease (COPD)
• asthma
• pneumonia
• tuberculosis
• cystic fibrosis

These lung conditions can weaken the edge of your lung, making it more likely to tear and let air escape.

Traumatic pneumothorax

This type of pneumothorax is caused by trauma, such as:

• a car accident
• broken ribs
• a stab wound

A traumatic pneumothorax can also happen after a medical procedure.

See your doctor straight away if you get symptoms of a pneumothorax.

A tension pneumothorax is a medical emergency. Call triple zero (000) for an ambulance straight away if you have difficulty breathing.

Your doctor will ask about your symptoms and examine you. They will listen to your chest with a stethoscope.

A chest x-ray is usually recommended to diagnose a pneumothorax. Sometimes you may also need a CT scan or ultrasound scan of the chest.

Treatment for your pneumothorax will be guided by:

• your symptoms
• the type of pneumothorax
• the size of the pneumothorax

Observation

If you have a primary spontaneous pneumothorax and only minor symptoms, your pneumothorax might get better on its own. Symptoms usually get better within 7 to 14 days without specific treatment.

Your doctor may recommend:

• observation in hospital
• oxygen (if needed)
• pain-relief medicines

You might need to have a repeat chest x-ray after a couple of weeks.

Tension pneumothorax is very rare in people with a primary spontaneous pneumothorax.

Removal of trapped air

You may need to have the trapped air removed from the pleural space if you have:

• ongoing symptoms
• an underlying lung condition

'Catheter aspiration' involves inserting a thin tube into your chest wall. Local anaesthetic will numb your skin beforehand. A syringe attached to a tube is used to suck the air out. The tube is often left in place for several days. This lets out any air that builds up.

It's possible to get a persistent air leak if you had a chest drain put in for a pneumothorax.

If this happens, your lung specialist will recommend treatment for your situation.

If you've had a spontaneous pneumothorax, you're at increased risk of having another one.

Changes in air pressure can cause another pneumothorax. Talk to your doctor before:

• travelling by plane
• travelling to high altitudes

If you've had a pneumothorax, your doctor will likely advise against underwater diving.

Treatments to prevent pneumothorax

Quitting smoking or vaping can reduce your chance of having another pneumothorax.

Some people will need a procedure called a pleurodesis to stop having another pneumothorax. Pleurodesis aims to stick your lung to your chest wall.

Lung Foundation Australia (Opens in new tab) offers support and resources for people with lung conditions.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.