Tension pneumothorax (summary)
Updates to Article Attributes
A tension pneumothoraxpneumothorax under pressure. The increasing pressurea tension pneumothorax compressestraining grades. If you've arrived here by accident, and need more information, head to the contents of the hemithoraxmain tension pneumothorax article.
Tension pneumothoraces are pneumothoraces under pressure. If the pressure gets high enough, the pneumothorax can compress the heart and great vessels, and even cause cardiac arrest.
CausesClinical presentation
Presentation is usually with respiratory compromise and chest pain, although if the pneumothorax is under enough pressure, it may impact venous return with resultant distended neck veins and eventual circulatory collapse and cardiac arrest.
Pathophysiology
A tension pneumothorax occurs when there is progressive accumulation of gas within the pleural cavity. This is usually caused by a ball-valve effect with progressive increases in intrapleural air during each expiration. As the amount of gas increases in a fixed volume, the pressure increases.
Radiographic features
Pneumothoraces are seen as areas of increased lucency. Tension pneumothoraces tend to be large and result in relative lucency of the entire hemithorax. Associated mass effect on ribs, diaphragm and mediastinum results in increased rib spacing, depression of the diaphragm and displacement of the mediastinum to the contralateral side of the chest.
See alsoTreatment and prognosis
must be diagnosed early and treated with urgency. Initial decompression with a needle or cannula in the 2nd intercostal space anteriorly will reduce the pressure.A chest drain should be inserted to ensure that tension does not recur. Assessment should include attempts to determine the underlying cause. If treated early with appropriate drainage, prognosis is excellent.
-<p>A <strong>tension pneumothorax</strong> is a <a title="Pneumothorax (basic)" href="/articles/pneumothorax-basic">pneumothorax</a> under pressure. The increasing pressure in a tension pneumothorax compresses the contents of the hemithorax. If the pressure gets high enough, the pneumothorax can compress the heart and great vessels and even cause cardiac arrest.</p><h4>Causes</h4><h4>Radiographic features</h4><h4>See also</h4><ul><li><a title="Pneumothorax (basic)" href="/articles/pneumothorax-basic">pneumothorax</a></li></ul>- +<p>This is a <em>basic article</em> which is aimed at medical students and non-radiologists in training grades. If you've arrived here by accident, and need more information, head to the main <a href="/articles/tension-pneumothorax">tension pneumothorax</a> article.</p><p><strong>Tension pneumothoraces</strong> are <a href="/articles/pneumothorax-basic">pneumothoraces</a> under pressure. If the pressure gets high enough, the pneumothorax can compress the heart and great vessels, and even cause cardiac arrest.</p><h4>Clinical presentation</h4><p>Presentation is usually with respiratory compromise and chest pain, although if the pneumothorax is under enough pressure, it may impact venous return with resultant distended neck veins and eventual circulatory collapse and cardiac arrest.</p><h4>Pathophysiology</h4><p>A tension pneumothorax occurs when there is progressive accumulation of gas within the pleural cavity. This is usually caused by a ball-valve effect with progressive increases in intrapleural air during each expiration. As the amount of gas increases in a fixed volume, the pressure increases.</p><h4>Radiographic features</h4><p>Pneumothoraces are seen as areas of increased lucency. Tension pneumothoraces tend to be large and result in relative lucency of the entire hemithorax. Associated mass effect on ribs, diaphragm and mediastinum results in increased rib<span style="line-height:1.6em"> spacing, depression of the diaphragm and displacement of the mediastinum to the contralateral side of the chest.</span></p><h4>Treatment and prognosis</h4><p>A tension pneumothorax must be diagnosed early and treated with urgency. Initial decompression with a needle or cannula in the 2nd intercostal space anteriorly will reduce the pressure.</p><p>A chest drain should be inserted to ensure that tension does not recur. Assessment should include attempts to determine the underlying cause. <span style="line-height:1.6em">If treated early with appropriate drainage, prognosis is excellent.</span></p>
Systems changed:
- Chest
Tags changed:
- uoe
Image 4 X-ray (Frontal) ( create )
Image 5 X-ray (Frontal) ( create )
Image 6 CT (lung window) ( create )
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