Collapsed Lung

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Introduction

What is a collapsed lung?

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 a pneumothorax, an accumulation of air in the chest that prevents the lungs from expanding fully, or to atelectasis, deflation of the tiny air sacs (alveoli) within the lungs.

More specifically, 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 problems and conditions.

A collapsed lung can occur spontaneously but most often occurs in hospitalized patients undergoing certain procedures and people who experience chest trauma. Certain lung diseases, such as chronic obstructive pulmonary disease (COPD), asthma, and cystic fibrosis, increase the risk of a collapsed lung, as does participation in certain activities, such as scuba diving and high-altitude climbing or hiking.

The characteristic symptom of a collapsed lung from pneumothorax is severe, sharp chest pain and difficulty breathing. Atelectasis symptoms include possible chest pain or pressure, cough, and difficulty breathing. Treatment for a collapsed lung includes procedures to re-inflate the affected lung, ease breathing, and increase oxygenation. In rare cases, surgery is required to repair the damaged lung. Remembering to take deep breaths every hour, if you are bedridden or have pain with breathing, can prevent atelectasis.

Left untreated, a collapsed lung can lead to serious symptoms. Seek immediate medical care (call 911) for severe difficulty breathing, bluish coloration of the lips or fingernails, and severe sharp chest pain.

Seek prompt medical care if you are being treated for a collapsed lung but mild symptoms recur or are persistent.

Symptoms

What are the symptoms of a 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.

Symptoms of a collapsed lung due to pneumothorax

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

Symptoms of a collapsed lung due to atelectasis

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

Serious symptoms that might indicate a life-threatening condition

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

Causes

What causes a collapsed lung?

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.

Pneumothorax-related causes of collapsed lung

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-related causes of lung collapse

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

What are the risk factors for a collapsed lung?

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

Treatments

How is a collapsed lung treated?

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.

Pneumothorax treatment options to re-inflate a collapsed lung

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)

Atelectasis treatment options to re-inflate a collapsed lung

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)

What are the potential complications of a collapsed lung?

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

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jan 4
  1. Atelectasis. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001130/.
  2. Collapsed lung (pneumothorax). PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001151/
  3. Tierney LM Jr., Saint S, Whooley MA (Eds.) Current Essentials of Medicine (4th ed.). New York: McGraw-Hill, 2011.
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