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Tension pneumothorax tends to occur in clinical situations such as ventilation, resuscitation, trauma, or in people with lung disease. [15] It is a medical emergency and may require immediate treatment without further investigations (see Treatment section). [15] [16]
Left-sided tension pneumothorax. Note the area without lung markings which is air in the pleural space. Also note the tracheal and mediastinal shift from the patient's left to right. Causes include any obstruction of blood flow to and from the heart. There are multiple, including pulmonary embolism, cardiac tamponade, and tension pneumothorax.
Obstructive shock may be due to cardiac tamponade or a tension pneumothorax. [1] Distributive shock may be due to sepsis, anaphylaxis, injury to the upper spinal cord, or certain overdoses. [1] [4] The diagnosis is generally based on a combination of symptoms, physical examination, and laboratory tests. [2]
Left tension pneumothorax with a large, well-demarcated area devoid of lung markings with tracheal deviation and movement of the heart away from the affected side. Mediastinal shift is an abnormal movement of the mediastinal structures toward one side of the chest cavity .
In the emergency department the typical approach to chest pain involves ruling out the most dangerous causes: heart attack, pulmonary embolism, thoracic aortic dissection, esophageal rupture, tension pneumothorax, and cardiac tamponade. By elimination or confirmation of the most serious causes, a diagnosis of the origin of the pain may be made.
Therefore, pneumothorax is usually more of a problem than hemothorax. [8] A pneumothorax may form or be turned into a tension pneumothorax by mechanical ventilation, which may force air out of the tear in the lung. [12] The laceration may also close up by itself, which can cause it to trap blood and potentially form a cyst or hematoma. [8]
An additional problem in these cases is that those with other features of decompression sickness are typically treated in a diving chamber with hyperbaric therapy; this can lead to a small pneumothorax rapidly enlarging and causing features of tension. [36] Diagnosis of a pneumothorax by physical examination alone can be difficult (particularly ...
The affected lung "collapses" like a deflated balloon. A tension pneumothorax is a particularly severe form of this condition where the air in the pleural cavity cannot escape, so the pneumothorax keeps getting bigger until it compresses the heart and blood vessels, leading to a life-threatening situation.