Pneumothorax Vs Tension Pneumothorax: Know the Differences

Pneumothorax Vs Tension Pneumothorax

Pneumothorax Vs Tension Pneumothorax: Pneumothorax, commonly called a collapsed lung, occurs when air leaks into the space between the lung and chest wall. This can cause mild discomfort or significant shortness of breath. Pneumothorax vs Tension Pneumothorax: While most resolve on their own (simple pneumothorax), a tension pneumothorax traps air, creating a one-way valve. This trapped air compresses the good lung and heart, becoming life-threatening if not treated urgently with a chest tube. Tension pneumothorax usually results from trauma or medical procedures, but rarely can even occur spontaneously. If you experience sudden, sharp chest pain and difficulty breathing, seek immediate medical attention.

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Difference Between Pneumothorax and Tension Pneumothorax

Both tension pneumothorax and pneumothorax are medical diseases that cause the lung's wall to split from the pleural space, causing the lung to collapse. Their appearance, pathophysiology, and therapy, however, varies greatly. The following summarises the differences between tension and pneumothorax:



Tension Pneumothorax


Presence of air in pleural space without significant respiratory compromise

Life-threatening condition with progressive lung collapse and hemodynamic compromise


Air enters pleural space due to lung or airway rupture

One-way valve mechanism traps air in pleural space

Clinical Features

Chest pain, dyspnea, decreased breath sounds

Severe respiratory distress, hypotension, tracheal deviation, jugular venous distention, decreased breath sounds


May remain stable or resolve spontaneously

Worsens rapidly, leading to cardiovascular collapse if untreated


Observation, supplemental oxygen, chest tube insertion if necessary

Immediate decompression (needle thoracostomy) followed by chest tube insertion


Lung collapse, hypoxemia

Rapid progression to cardiac arrest

Imaging Findings

Visible pleural line, absence of lung markings beyond it

Mediastinal shift, "collapsed" lung appearance


Can occur alone or with hemothorax

Primarily characterized by air accumulation, but hemothorax can also coexist

Respiratory Compromise

Can lead to respiratory compromise

Causes severe and rapidly progressing respiratory distress


Generally good with prompt management

Requires immediate intervention to prevent mortality

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What is Pneumothorax?

A pneumothorax is a build-up of air between the chest wall and the lung that occurs outside the lung but inside the chest cavity. Breathing becomes challenging due to the possibility of lung collapse caused by this air. Pneumothorax can happen on their own, as a result of trauma to the chest, or as a result of underlying lung diseases such as cystic fibrosis or COPD. Shortness of breath, coughing, and an abrupt, intense chest discomfort are possible symptoms.

Key Features of Pneumothorax:

  • Pneumothorax occurs when air leaks into the pleural space, the thin cavity between your lung and chest wall. This disrupts normal pressure, causing partial or complete lung collapse.
  • Spontaneous pneumothorax happens without external injury, often in young, tall men due to blebs (thin-walled lung bubbles) bursting. Traumatic pneumothorax arises from chest injuries like punctures or rib fractures.
  • Small leaks might cause mild chest pain and shortness of breath. Larger leaks can lead to severe respiratory distress, blue-ish skin (cyanosis), and even shock.
  • Small pneumothorax might resolve on its own. Larger leaks often require a chest tube insertion to drain air and reinflate the lung. Surgery might be needed for recurrent cases.

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What is Tension Pneumothorax?

A potentially fatal medical emergency known as a tension pneumothorax is brought on by air being trapped in the chest cavity and creating pressure. The heart and other organs may receive less blood flow as a result of this pressure compressing the lung and large blood veins. There are several causes of tension pneumothorax, such as medical procedures, trauma, and underlying lung disorders. Severe chest discomfort, breathing difficulties fast breathing, and blue skin tone are some of the symptoms

Key Features of Tension Pneumothorax:

  • The narrow gap between your lung and chest wall, known as the pleural space, is where air seeps into and causes pneumonia. Lung collapse, either partial or total, results from this disturbance of normal pressure.
  • When blebs—thin-walled lung bubbles—burst, it causes spontaneous pneumothorax, which typically affects young, tall males without any exterior injuries. Chest traumas such as punctures or fractured ribs can result in traumatic pneumothorax.
  • Breathlessness and minor chest discomfort might be caused by small leaks. Extensive leakage may result in shock, cyanosis, or really bad respiratory distress.
  • Small pneumothorax may go away on their own. Chest tubes are frequently used for larger leaks in order to relieve air and reinflate the lung. For recurring situations, surgery could be required.

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Similarities Between Pneumothorax and Tension Pneumothorax

  • Pneumothorax and tension pneumothorax, both involve the accumulation of air in the pleural space.
  • They can both present with dyspnea and chest pain.
  • Diagnosis is typically made through clinical evaluation and confirmed by imaging (e.g., chest X-ray).
  • They both require intervention for management, ranging from observation to invasive procedures like chest tube insertion.
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What are the Similarities between Pneumothorax and Tension Pneumothorax?

Both pneumothorax and tension pneumothorax involve the presence of air in the pleural space, which can lead to lung collapse. They can both cause similar symptoms such as chest pain, shortness of breath, and respiratory distress.

How do Pneumothorax and Tension Pneumothorax Differ?

The key difference lies in the dynamics of air accumulation and pressure buildup. In pneumothorax, air enters the pleural space but does not cause significant pressure increase. In tension pneumothorax, air accumulates rapidly and cannot escape, leading to increasing pressure within the pleural cavity.

What are the Features of Pneumothorax?

Pneumothorax may present with sudden onset of chest pain, shortness of breath, and decreased breath sounds on the affected side. It can be caused by trauma, lung disease, or occur spontaneously.

What are the Features of Tension Pneumothorax?

Tension pneumothorax presents as a medical emergency with rapidly worsening respiratory distress, hypotension, tracheal deviation, and absent breath sounds on the affected side. It requires immediate intervention to prevent further complications.

How is Pneumothorax Diagnosed?

Diagnosis typically involves clinical evaluation, chest X-ray, and sometimes CT scan. Physical examination findings such as decreased breath sounds and hyperresonance on percussion may also suggest pneumothorax.