Secondary Pneumothorax

Secondary spontaneous pneumothorax occurs in the setting of a variety of lung diseases. The most common is COPD, which accounts for approximately 70% of cases.  Known lung diseases that may significantly increase the risk for pneumothorax are diseases of the airways (COPD, severe asthma, cystic fibrosis), infections of the lung, interstitial lung disease, connective tissue disease, and cancer. (adapted from wikipedia)

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Case Summary: “A 65-year-old man with a 50-pack-year smoking history complains of sudden-onset, severe shortness of breath that began 4 hours ago. The shortness of breath is associated with mild left-sided chest pain when he takes a deep breath. He denies experiencing any precordial chest pain, nausea, vomiting, or diaphoresis. He states that the pain does not extend to his extremities. The patient does not have a history of heart disease or a history of diseases in his family.

On physical examination, the patient has a normal blood pressure of 124/87 mm Hg, with a resting heart rate of 115 beats/min. His respiratory rate is 25 breaths/min, with an oxygen saturation of 82% on room air.  He is in mild respiratory distress but can speak in full sentences without difficulty. His lung sounds are difficult to auscultate, but they seem to be diminished on the left side. The results of his cardiac examination are normal, with no gallop or jugular venous distention.” (reblogged from Medscape, case provided by Dr. Michael Cetta)

It was determined that this patient had a secondary spontaneous pneumothorax, the chest radiograph shows a left sided pneumothorax of approximately 50% the volume of the left lung

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