Clinical features
A tension pneumothorax may present with:
- breathlessness
- sudden onset of unilateral pleuritic chest pain
- cyanosis
- tachypnoea
- hypotension and cardiorespiratory collapse
Examination reveals:
- deviation of the trachea and apex beat away from the the affected side
- reduced or absent chest expansion on the affected side
- hyper-resonant percussion note on the affected side
- reduced breath sounds
- reduced or absent vocal resonance
Chest radiography confirms the diagnosis, and also may show surgical emphysema in the case of accompanying rib fracture. However, the condition is an emergency - the patient may die within minutes - and so the diagnosis is made clinically.
Reference:
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