Pneumothorax clinical manifestations

Written by Yuan Qing
Pulmonology
Updated on April 01, 2025
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Pneumothorax is primarily caused by various factors, both internal and external to the lungs, leading to a significant accumulation of gas within the chest cavity. Patients exhibit symptoms such as chest tightness, breathlessness, including coughing, chest pain, and other related symptoms, which are collectively referred to as pneumothorax. Patients with pneumothorax can be classified into mild and severe types. Generally, after the onset of pneumothorax, patients who only experience symptoms like panting, chest tightness, chest pain, or coughing, but maintain stable blood pressure and heart rate, are considered to have a mild condition. However, if in addition to these respiratory symptoms, the patient clearly exhibits a drop in blood pressure, a decrease in oxygen saturation, or a reduction in heart rate, these conditions are considered severe and require urgent treatment.

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Written by Li Hu Chen
Imaging Center
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How to Read a Pneumothorax X-ray

Pneumothorax has typical manifestations on a chest X-ray. Normally, the pulmonary markings on both sides are quite clear and visible. However, when a pneumothorax occurs, the part of the lung tissue with these markings tends to be compressed due to the accumulation of a large amount of gas in the surrounding pleural cavity, pushing the lung to contract towards the center. Around the periphery, these lung margins, which are outside the lung, meaning inside the pleural cavity, display the gas as very uniform and fine, without any markings. This is because it is pure gas, simply air, hence it is impossible for it to have markings. There is a particularly distinct demarcation line, a thin line, between this part of the pleural cavity and the lungs. Through these features, one can determine the presence of a pneumothorax.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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How to check for hemothorax and pneumothorax?

Actually, the examination methods for hemothorax and pneumothorax are quite simple. From their definitions, we know that hemothorax means the abnormal presence of blood in the pleural cavity, and pneumothorax means the presence of gas in the pleural cavity where it shouldn't be. Therefore, the simplest examination is an X-ray, a standard frontal and lateral chest X-ray, which usually costs about 52 yuan, can detect whether a patient has pneumothorax. As for hemothorax, of course, it involves the use of a syringe. After injecting some lidocaine local anesthesia into the patient, if blood is withdrawn from the pleural cavity, then it indicates a hemothorax. Thus, the first step in examining for hemothorax and pneumothorax is to perform an X-ray to check for the presence of gas. If gas is detected, then it is pneumothorax. If liquid is found, a syringe under ultrasound guidance can be used to withdraw it. If the withdrawal yields fluid, it indicates pleural effusion; if blood is drawn, then it indicates hemothorax.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Foods to avoid with pneumothorax

We know that the lung tissue of a normal person is like a balloon. When breathing, this balloon expands and contracts, and there are about hundreds of millions of small structures in the lungs like balloons, which we call alveolar tissue. This structure also continuously expands and contracts, expelling carbon dioxide and inhaling oxygen. For certain reasons, such as infection or due to the body shape of tall, thin young people, or chronic obstructive pulmonary disease (COPD) and bronchitis in elderly people, this alveolar structure can rupture, causing some alveoli to merge into a large bulla. Of course, if the large bulla eventually ruptures, the break in this balloon-like surface will leak air into the pleural cavity, causing a pneumothorax. As for the nutrition from food, we believe that patients should not refrain from certain foods, but should instead increase their intake of protein, such as eating three to four egg whites daily. If worried about high cholesterol, discard the yolk, consuming only one yolk per day, but ensuring adequate protein intake. Therefore, for patients with pneumothorax, it is not about avoiding certain foods, but about eating more of those foods to which they are not allergic, such as shrimp and beef, rather than restricting their diet.

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Written by Yuan Qing
Pulmonology
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Pneumothorax clinical manifestations

Pneumothorax is primarily caused by various factors, both internal and external to the lungs, leading to a significant accumulation of gas within the chest cavity. Patients exhibit symptoms such as chest tightness, breathlessness, including coughing, chest pain, and other related symptoms, which are collectively referred to as pneumothorax. Patients with pneumothorax can be classified into mild and severe types. Generally, after the onset of pneumothorax, patients who only experience symptoms like panting, chest tightness, chest pain, or coughing, but maintain stable blood pressure and heart rate, are considered to have a mild condition. However, if in addition to these respiratory symptoms, the patient clearly exhibits a drop in blood pressure, a decrease in oxygen saturation, or a reduction in heart rate, these conditions are considered severe and require urgent treatment.

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home-news-image
Written by Zhang Zhi Gong
Cardiothoracic Surgery
1min 15sec home-news-image

How many days after pneumothorax can one smoke?

For patients with pneumothorax, it is advised to strictly quit smoking, as smoking greatly increases the recurrence of pneumothorax. Smoking leads to airway inflammation and respiratory bronchitis. Among male patients with pneumothorax, compared to non-smokers, smokers have a significantly higher incidence of pneumothorax, which is related to the degree of smoking. If the patient smokes less than half a pack, the recurrence rate of his pneumothorax is about 7 times higher. For moderate smokers, those who smoke between half a pack and one pack, the recurrence rate increases to 21 times. If one smokes a pack a day, the recurrence rate rises to 102 times, this is in males. In females, for those smoking less than half a pack, between half a pack and one pack, and more than one pack, the recurrence rates of pneumothorax become 4 times, 14 times, and 68 times respectively. Therefore, for both male and female patients with pneumothorax, smoking significantly increases the probability of recurrence. So, once pneumothorax is resolved, quit smoking as well, to prevent any future recurrences.