Pneumothorax occurs when air gains access to, and accumulates in, the pleural space

Types:

• A primary spontaneous pneumothorax occurs in young people without known respiratory illnesses.
• A secondary spontaneous pneumothorax occurs in patients with pre-existing pulmonary diseases.
  • Connective tissue disease (such as Marfan's syndrome and Ehlers-Danlos syndrome)
  • Obstructive lung disease (such as asthma and COPD)
  • Infective lung disease (such as TB and pneumonia)
  • Fibrotic lung disease (such as cystic fibrosis and idiopathic pulmonary fibrosis),
  • Neoplastic disease (such as bronchial carcinoma)
• Tension pneumothorax - PTX with tracheal deviation
  • A tension pneumothorax is a medical emergency that requires immediate decompression.

Risk factors:

• Pre-existing lung disease: COPD, severe asthma, CF, lung cancer, pneumocytis pneumonia
• Connective tissue disease - Marfan’s, RA
• Ventilation - including NIV
• catamenial PTX - the cause of 3-6% of spontaneous pneumothoraces occurring in menstruating women. It is thought to be caused by endometriosis within the thorax
• Chest trauma

PC

Symptoms/signs tend to come on suddenly, they include:

• Chest pain (pleuritic),
  • Primary spontaneous PTX may experience shoulder tip pain
• Dyspnoea
• Ipsilateral reduced breath sounds and hyperinflation + hyperresonance