Tension pneumothorax

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Tension pneumothorax

  • This is the one not to miss. If you cannot diagnose a tension pneumothorax at medical finals you won't find an examiner who will defend you.
  • The left hemithorax is black due to air in the pleural cavity.

Signs of tension

  • The left lung is completely compressed (arrowheads).
  • The trachea is pushed to the right (arrow)
  • The heart is shifted to the contralateral side - note right heart border is pushed to the right (red line)
  • The left hemidiaphragm is depressed (orange line)

Important note

  • If you diagnose a tension pneumothorax clinically - do not request an X-ray - TREAT THE PATIENT!

Page author: Salisbury NHS Foundation Trust UK (Read bio)

Last reviewed: October 2019