Collapsed Lung

A collapsed lung is a deflation of the lungs, which affects normal breathing and leads to chest pain. Symptoms vary depending on whether the lung collapse is due to air between the chest wall and lungs (pneumothorax) or deflation of the small air sacs (alveoli) within the lungs (atelectasis). Symptoms can vary in intensity among individuals.

A collapsed lung due to pneumothorax is associated with a number of symptoms that may become severe at any time including:

• Bluish coloration of the lips or fingernails

• Coughing up blood (hemoptysis)

• Difficulty breathing

• Fatigue

• Nasal flaring to inhale more air

• Rapid breathing (tachypnea) or shortness of breath

• Rapid heart rate (tachycardia)

• Severe pain in the chest or shoulder

A collapsed lung due to atelectasis may manifest a number of symptoms, which may become severe at any time. Examples include:

• Cough

• Difficulty breathing

• Rapid breathing (tachypnea) or shortness of breath

• Shallow breathing

In some cases, a collapsed lung can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

• Bluish coloration of the lips or fingernails

• Change in level of consciousness or alertness, such as passing out or unresponsiveness

• Chest pain, chest tightness, chest pressure, palpitations

• Rapid heart rate (tachycardia)

• Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking

A collapsed lung is the deflation of some or all of a lung, resulting in difficulty breathing, chest pain, and low oxygen in the blood (hypoxia). Collapsed lung can refer to pneumothorax, an accumulation of air within the chest cavity, which prevents the lungs from expanding fully, or atelectasis, a deflation of the tiny air sacs (alveoli) within the lungs.

A collapsed lung resulting from a pneumothorax begins as a hole in the lung, which allows air to escape from inside the lung and inflates the space between the lung and the ribcage. Pressure from this enlarging pocket of air causes the lung to collapse. Atelectasis is often caused by a pneumothorax, but it can be a complication of many respiratory diseases. Blockage of the airways, such as with a foreign object, tumor, or mucus plug, can also lead to atelectasis.

Possible causes of pneumothorax, or air accumulation in the chest that prevents lung expansion, include chest trauma, underlying lung disease, or a ruptured bleb (small air-filled space in the lungs). Pneumothorax can also occur for no apparent reason.

• Bleb (small air-filled space in the lung) that bursts, often because of a change in air pressure

• Blow to the chest, such as from an air bag inflating

• Chest trauma, such as a knife or gunshot wound or a fractured rib

• Medical procedures, such as chest tube insertion, cardiopulmonary resuscitation (CPR), and lung biopsies

• Underlying lung disease, such as cystic fibrosis, emphysema, lung cancer, pneumonia, and tuberculosis

Atelectasis, or collapse of the small air sacs in the lungs, is typically caused by a blockage of the airways or pressure on the outside of the lungs. Specific causes of airway blockage and lung pressure include:

• Accumulation of mucus in the airways

• Blood clot

• Blow to the chest caused by a fall or car accident

• Foreign object in the airways

• Lung diseases, such as tuberculosis, that cause narrowing of the airways

• Lung tumor

• Pleural effusion (accumulation of fluid around the lungs)

• Pneumonia

A number of factors increase the risk of developing a collapsed lung. Not all people with risk factors will get a collapsed lung. Risk factors for a collapsed lung include:

• Activities such scuba diving, flying, or hiking at high altitudes

• Family history of pneumothorax

• History of lung disease (asthma, chronic obstructive pulmonary disease, cystic fibrosis, tuberculosis, or whooping cough)

• Long-term confinement to bed

• Obesity

• Recent anesthesia

• Smoking

Treatment for a collapsed lung begins with seeking medical care from your health care provider. The goal of treatment for a collapsed lung is to re-inflate the collapsed lung to ease breathing and improve oxygenation. Treatment depends on the severity of the collapsed lung and the cause.

Multiple options are available for treating a collapsed lung that is the result of a pneumothorax including:

• Needle aspiration of air (typically used to treat a small pneumothorax)

• Insertion of a chest tube with suction (usually performed to treat a large pneumothorax)

• Oxygen therapy

• Surgery (if other methods are not successful)

Treatment of atelectasis, or collapse of the small air sacs in the lungs, depends on the cause. In some cases when only a small area of the lungs has collapsed, the condition may resolve on its own. If treatment is necessary, options include:

• Acetylcysteine (Acetacote, Mucomyst) to thin mucus and make it easier to cough up mucus

• Bronchodilators to expand airways, such as albuterol (ProAir, Proventil, Ventolin) and levalbuterol (Xopenex)

• Bronchoscopy (procedure used to remove airway blockages)

• Chest physical therapy (CPT) to help clear mucus

• Incentive spirometer (device used to measure deep breathing)

• Positive pressure device, such as positive expiratory pressure (PEP)

Complications of an untreated collapsed lung can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of collapsed lung include:

• Hypoxia (low levels of oxygen in the blood)

• Pneumonia

• Respiratory failure and respiratory arrest

• Shock