What are the signs and symptoms of a tension pneumothorax?

The signs and symptoms of a tension pneumothorax include decreased breath sounds on one side, tracheal deviation, hypotension, and distended neck veins. In this condition, air becomes trapped in the pleural space and creates pressure that can collapse the lung on the affected side.

Decreased breath sounds on the side of the pneumothorax occur because the lung is unable to fully expand due to the pressure from the trapped air. Tracheal deviation can happen as well; typically, the trachea shifts away from the affected side as pressure builds up in the pleural cavity. This is a critical finding as it indicates a significant displacement of mediastinal structures due to the increased pressure.

Hypotension is a result of reduced venous return to the heart; as the pressure inside the thoracic cavity increases, it can compress the great vessels and impact blood flow. Distended neck veins are visually apparent because the increased intrathoracic pressure impedes venous return from the head and neck, leading to engorgement of the neck veins.

These clinical signs underscore the urgency of recognizing a tension pneumothorax as a life-threatening emergency that necessitates immediate intervention, often through needle decompression or chest tube placement