[QxMD MEDLINE Link]. Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. Although tension pneumothorax may be a difficult diagnosis to make and may present with considerable variability in signs, respiratory distress and chest pain are generally accepted as being universally present, and tachycardia and ipsilateral air entry on auscultation are also common findings. Hyper-expansion. Computed tomography scan demonstrating a bulla in an asymptomatic patient. - answerA) increased work of breathing B) unilaterally diminished breath sounds C) pleuritic chest pain D) hypotension that worsens with inspiration *** D ) http://creativecommons.org/licenses/by-nc-nd/4.0/ Computed tomography scan demonstrating emphysematouslike changes (ELCs) in a patient with chronic obstructive pulmonary disease (COPD). Rarely, it is a complication of traumatic pneumothorax, when a chest wound acts as a one-way valve that traps increasing volumes of air in the pleural space during inspiration. Tension pneumothorax is primarily a clinical diagnosis and prolonged diagnostic studies should be avoided in favor of initiating immediate treatment. Causes include pulmonary embolism, cardiac tamponade, and tension pneumothorax. Symptoms may include diaphoresis, splinting chest wall to relieve pleuritic pain, and cyanosis (in the case of tension pneumothorax). Tension pneumothorax can cause rapid progression of hypoxia, hypotension and shock. 1993. Tension pneumothorax is a life-threatening condition caused by the continuous entrance and entrapment of air into the pleural space, thereby compressing the lungs, heart, blood vessels, and other structures in the chest. Abdominal distention may occur from increased pressure in the thoracic cavity producing caudal deviation of the diaphragm and from secondary pneumoperitoneum produced as air dissects across the diaphragm through the pores of Kohn. [QxMD MEDLINE Link]. Hearnshaw SA, Oppong K, Jaques B, Thompson NP. Until a bleb ruptures and causes pneumothorax, no clinical signs or symptoms are present in primary spontaneous pneumothorax (PSP).
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