Sunday, 24 November 2013

Pleural disease – Pneumothorax – The Symptoms

The pleura is a thin tissue covered by a layer of cells (mesothelial cells) that surrounds the lungs and lines the inside of the chest wall.
A. Pneumothorax is defined as a condition of collection of air within the pleural cavity, from either the outside or from the lung of which affect the lung breathing.
A. Symptoms
The most common symptoms of Pneumothorax are
1. Chest pain and breathlessness
There is report of a 43-year-old man presented to his family physician with generalized pain over the right side of his chest following a harsh bout of coughing. The pain rapidly increased in severity over a period of 1 hour and also began radiating to his right arm. He also began to feel increasingly breathless. In view of the patient’s history, physical examination, and chest radiograph findings, a diagnosis of right-sided tension pneumothorax was made and urgent chest decompression was performed with a needle thoracostomy(1).
2. Dyspnoea
Dyspnoea, defined as an uncomfortable awareness of breathing ( difficult or labored breathing and shortness of breath), together with thoracic pain are two of the most frequent symptoms of presentation of thoracic diseases. According to the study, causes of dyspnoea are various and involve not only cardiovascular and respiratory systems, including pulmonary embolism, pneumothorax, and pulmonary edema(2).
3. Acute abdominal symptoms
There is a report of two cases of a 25 year-old and a 37 year-old male presenting with acute abdominal symptoms and later were both diagnosed as Pneumothorax(3)
4. Other symptoms
According to the study of a two-year-old male presented to the emergency department (ED) with a four-day history of evening tactile fevers, measured to 38.1ºC at home, associated with symptoms of a worsening cough, congestion, mild diarrhea, emesis, decreased oral intake and level of activity. A chest x-ray was obtained, which revealed a large right-sided pneumothorax with a leftward shift of the mediastinum(4).
According to the study to evaluated retrospectively in 219 patients, predominantly smokers who had had spontaneous pneumothorax, for the first time, indicated that moderate exertion was recorded in only 2%, and no patients were exerting themselves heavily when the symptoms began. The occurrence of spontaneous pneumothorax was unevenly (p less than 0.001) distributed over the day. In 9% the symptoms had their onset during quick movement–such as fastening a seat belt–without any effort(5)

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