Tension pneumothorax

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Chest tube insertion - series

Pneumothorax - chest X-ray

Respiratory system

Pneumothorax - tension

• 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
• Consciousness, decreased
• Breathing, rapid
• Distended neck veins (the veins in the neck appear to bulge)

Physical examination may show decreased breath sounds when listening to the chest with a stethoscope. Structures in the mediastinum (center of the chest) may appear shifted. Subcutaneous emphysema (air trapped in the tissue of the chest wall) may be present, causing a spongy feeling when the chest is felt with the hands (palpation).

In general, if a health care provider suspects tension pneumothorax, treatment should start before diagnostic tests are done. Nonetheless, some tests may help confirm the diagnosis if there is doubt or to assess the severity of the situation:

Tests used in the diagnosis of tension pneumothorax include:

• A  chest x-ray
• Arterial blood gases
• Electrocardiogram

Review Date: 08/10/2005
Reviewed By: David A. Kaufman, M.D., Assistant Professor, Division of Pulmonary, Critical Care & Sleep Medicine, Mount Sinai School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network.