Tension pneumothorax

Symptoms:

• sudden chest pain
• shortness of breath
• chest tightness
• easy fatigue
• bluish color of the skin due to lack of oxygen
• rapid heart rate
• low blood pressure
• decreased mental alertness
• wheezing
• consciousness, decreased
• breathing, rapid
• distended neck veins (the veins in the neck appear to bulge)

Signs and tests:

Physical examination may show decreased breath sounds when listening to the chest with a stethoscope. There may be evidence of mediastinal shift (heart, trachea, esophagus and great vessels shifted towards unaffected lung). Subcutaneous emphysema (air trapped in the subcutaneous tissue of the chest wall) may be present, causing a spongy feeling when the chest is felt with the hands (palpation).

Tests used in the diagnosis of tension pneumothorax include:

• a chest X-ray
• arterial blood gases