The lungs are one of the most important organs in our body, helping provide the body with a continuous supply of oxygen within the respiratory system. The lungs normally take more than 6 million breaths per year and affect every aspect of our bodies and overall health.
The lungs’ ultimate role is to bring in air from the atmosphere and pass oxygen into the bloodstream. From there, it circulates to the rest of the body. The organs require help from surrounding structures in the body in order to breathe properly. To breathe, we use the muscle of the diaphragm, the intercostal muscles between the ribs, the muscles of the abdomen, and sometimes even muscles in the neck.
The lungs also reside in the chest, behind the rib cage on either side of the heart. They are roughly conical in shape with a rounded point at their apex and a flatter base where they meet the diaphragm.
A collapsed lung (pneumothorax) occurs when air enters the pleural space, the area between the chest wall and the lung. Air in that area can build up and push against the lung, causing it to collapse either partially or fully. This condition is considered serious and will require immediate medical care. Furthermore, there are five main types of a collapsed lung, which are listed below:
- Primary spontaneous pneumothorax – Collapsed lung often occurs in patients who do not have other lung problems. It can occur due to abnormal air sacs in the lungs that break apart and release air.
- Secondary spontaneous pneumothorax – Many lung diseases can lead to a collapsed lung. Some of these diseases include cystic fibrosis, emphysema, and chronic obstructive pulmonary disease (COPD).
- Injury-related collapsed lung – Injury directly to the chest may result in a collapsed lung. Some people experience a collapsed lung due to a fractured rib, a hard hit to the chest, or a knife or gunshot wound.
- Iatrogenic pneumothorax – There are certain medical procedures that can lead to complications including a collapsed lung, including lung biopsy, or a central venous line insertion.
- Catamenial pneumothorax – This condition affects women who have another condition known as endometriosis. Endometrial tissue lines the uterus. Endometriosis grows outside the uterus and attaches to an area inside the chest. The endometrial tissue forms cysts that bleed into the pleural space, causing the lung to suddenly collapse.
Causes & Symptoms of a Collapsed Lung
A collapsed lung can develop in numerous ways, such as:
- Lung disease – Tissue that is damaged is more likely to tear, allowing air to leak out. This is especially true with chronic obstructive pulmonary disease.
- Injury – such as a broken rib or gunshot wound can puncture your lung. In severe cases, the escaping air can build up pressure on your lung and heart, which may cause life-threatening problems such as loss of blood pressure. Other types of injuries that could cause a collapsed lung include certain types of ventilation or changes to ventilation, blunt trauma, and a stab wound.
- Air blisters – Sacs full of air, called blebs, may form on the outside of your lung and then burst, creating pressure.
- Your period – Cysts would form inside your chest. Within about 3 days before or after the beginning of your period, the cysts release blood between the lung and chest.
Symptoms of a collapsed lung typically occur during the period of trauma or just after. In contrast, symptoms of a spontaneous non-traumatic pneumothorax usually occur when you are at rest.
Sudden, severe chest pain is often the first symptom of a collapsed lung. However, a collapsed lung may also feel like a sharp, stabbing chest pain that worsens on breathing or with deep inspiration. This is referred to as pleuritic because it comes with irritation of nerve endings in the pleura (inner lining of the rib wall). Other symptoms linked to a collapsed lung also include:
- Abnormally fast heart rate (tachycardia).
- Difficulty catching your breath.
- Breathlessness on exertion.
- Rapid breathing.
- Loss of consciousness (coma).
- Blue discoloration of the skin or lips.
- Pressure in the chest that worsens over time.
- A dry, hacking cough that occurs due to the irritation of the diaphragm.
- Pain that often radiates to the shoulder and / or back.
Who gets a Collapsed Lung?
Below is a grand list of risk factors that may result in the development of a collapsed lung (pneumothorax):
Children
Pneumothorax can occur suddenly in children, although this is uncommon. Another cause is meconium aspiration. This is when a baby is still in the mother’s uterus and breathes in its first stool (meconium). Air may then become trapped, causing the lungs to expand too much. This can lead to air leaks.
Height
Oftentimes, very tall, thin people are prone to spontaneous pneumothorax. In this condition, the lung collapses after minimal or no trauma.
Smoking
People who smoke on a regular daily basis are at an increased risk of developing a collapsed lung. Also, recreational drug users who inhale deeply and forcefully are at a greater risk.
Scuba diving
People who scuba dive or go deep-sea diving may be at a high risk of experiencing a collapsed lung due to having low oxygen inside the scuba diving tank.
Gender
Females are prone to a collapsed lung. As mentioned earlier, catamenial pneumothorax is a condition that affects women in which air or gas is trapped in the space surrounding the lungs causing the lungs to collapse. Women with catamenial pneumothorax have recurrent episodes of pneumothorax that occur within 72 hours before or after the start of menstruation.
How Does a Collapsed Lung Affect You? How Serious is it?
Despite having many types of a collapsed lung that can affect anyone, there is another serious condition that requires urgent medical attention, which is called a tension pneumothorax.
This condition is a life-threatening condition caused by the continuous entrance and entrapment of air into the pleural space, thereby compressing the lungs, heart, blood vessels, and other structures in the chest. If this condition is left untreated, tension pneumothorax can rapidly progress to cardiovascular disease, which ultimately leads to cardiac arrest.
Other medical conditions that may also cause a collapsed lung include:
- Asthma
- Pneumonia
- Emphysema
- Lung cancer
- Tuberculosis
- Acute respiratory distress syndrome (ARDS), which is a condition caused by pneumonia.
Recommended Treatment & Rehabilitation for a Collapsed Lung
Unfortunately, diagnosing a collapsed lung can be quite difficult to accomplish due to the variety of symptoms and causes that are linked to this condition. In non-emergency situations, your doctor will first perform a physical examination to look for signs of a collapsed lung.
He or she may tap on your chest to check for abnormal sounds or listen to your breathing through a stethoscope. Your doctor will also ask you about your medical history and habits, such as smoking. Afterward, your doctor may order additional imaging tests to rule out other conditions associated with your injury, such as:
- X-ray – Your doctor will use an X-ray to take images of the chest and look for signs of a collapsed lung.
- Computed Tomography (CT) scan – CT scans are used to get a clearer picture of the lung than an X-ray provides. Doctors often use CT scans in trauma situations when they need a precise image of a puncture wound or other damage for treatment.
- Ultrasound – This is used in some situations and can provide a quick way to view the size and severity of a pneumothorax. Using ultrasound is far more sensitive than X-rays for examining blunt trauma.
Treatment for a collapsed lung is usually performed with oxygen followed by observation and rest if the collapse is minor. However, serious episodes of a collapsed lung may require the insertion of a chest tube to release trapped air and / or blood, thereby following the lungs to re-expand. Both surgery and hormonal therapy, either separately or in combination, will be used to treat women with catamenial pneumothorax.
Specific therapies may depend upon the exact cause of the collapsed lung, your age and general health and personal reference. Therefore, surgery may be done to remove (excise) all suspected areas of endometrial tissue in the lungs and pleural space and to repair any damage or holes within the diaphragm.
Surgery may also be performed to remove tiny blisters found on the top of the lungs. Another surgical procedure that has been used to treat women with catamenial pneumothorax involves a mesh made from specialized material.
During this procedure, a mesh is carefully placed over the diaphragm in order to block any small holes that may have been missed during surgery. The mesh is then absorbed over time and the scar tissue eliminates any remaining holes in the diaphragm.
After you have recovered from surgery or from non-surgical treatment, physiotherapy may be further advised.
Additional treatments will be designed by a physiotherapist may include a combination of the following:
Initial treatment
Rest from your physical activities. Additionally, limit the use of your chest and shoulder muscles. No pulling, pushing, lifting, or activity requiring heavy breathing. To initiate the pain relief, hold crushed ice in a plastic bag against the chest without adding pressure to the affected lung. Hold the ice, cycling 20-30 minutes on and off, for the first 24-72 hours.
Range-of-motion
To help combat chest pain and re-instate proper respiratory function, your physiotherapist will teach you ways how to practice slow and control your breathing. This will expand the chest, stretch the tissue surrounding the lungs, and re-establish the range of motion.
Muscle-strengthening
Even though rest is necessary initially for the chest muscles, they need to be strengthened later in the rehabilitation process. Begin by standing facing a wall. Then, plant your hands on the wall, directly in front of your shoulders, and perform small push-up movements against the wall. Repeat this training 10-12 repetitions for 3 sets a day.
Other light exercises can help minimize symptoms linked to a collapsed lung after recovery has been done – some exercise examples are targeted directly to your chest, such as:
Scapula squeeze
Wrap the band around your feet, then hold the band with your thumbs facing upwards. Next, keep your arms at your side with your shoulders down and relaxed. Pull your elbows back squeezing the shoulder blades together toward the back. Perform this stretch 10 times a day with 25 repetitions.
Foam Roller
Foam rollers are light foam tubes that can be used to improve flexibility as well as for self-massage. They can be used to roll out thigh muscles, which relieves tension and speeds up muscle recovery.
Doorway pectoral stretch
To perform this stretch, stand facing an open doorway. Then, raise your arm with your elbow bent 90 degrees. Rest your forearm against the wall with your elbows at shoulder height. Lastly, lean forward to gently stretch your chest muscles. Perform this stretch 2-3 times a day.
Alternative & Homeopathic Treatment for a Collapsed Lung
While your lung is healing, there is a lot you can do to help prevent further injury and ease your chest pain. Some of these homeopathic treatments include:
- Rest – Get plenty of rest and sleep. You may feel weak and tired for a while, but your energy level will improve with time.
- Supportive pillows – Hold a pillow against your chest when you cough or take deep breaths. This will support your chest and decrease your pain.
- Non-steroidal anti-inflammatory medications (NSAIDs) – Take pain medication in order to reduce pain.
- Avoid smoking – It is recommended to avoid smoking or allow others to smoke around you.
- Avoid certain activities – such as scuba diving, which can put extra pressure on your lungs for a time after your pneumothorax heals.