Q: 28 years old 'tall, thin, lean man' walked into the emergency room (ER) with severe acute right-sided chest pain associated with shortness of breath (SOB). Chest X-ray showed complete spontaneous pneumothorax (PTX) with mediastinal shift to left side. Patient qualifies as having 'tension' pneumothorax due to mediastinal shift.
A) True
B) False
Answer: B
This question aims to emphasize that 'tension' pneumothorax is defined by PTX, causing hemodynamic instability. The mediastinal shift does not qualify PTX as 'tension.'
Another clue in the question is the patient walking in the ER. At least one study determined that the ability to walk freely around the emergency department can be used as a clue for the stability of the PTX (reference #2).
Tall, lean thin males are prone to develop primary PTX.
#pulmonary
References:
1. Brown SGA, Ball EL, Perrin K, et al. Conservative versus Interventional Treatment for Spontaneous Pneumothorax. N Engl J Med 2020; 382:405.
2. Kelly AM, Clooney M, Spontaneous Pneumothorax Australia Study Group. Deviation from published guidelines in the management of primary spontaneous pneumothorax in Australia. Intern Med J 2008; 38:64.
3. Simpson G, Vincent S, Ferns J. Spontaneous tension pneumothorax: what is it and does it exist? Intern Med J. 2012 Oct;42(10):1157-60. doi: 10.1111/j.1445-5994.2012.02910.x. PMID: 23227475.
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