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In contrast, tension pneumothorax is a medical emergency and may be treated before imaging – especially if there is severe hypoxia, very low blood pressure, or an impaired level of consciousness. In tension pneumothorax, X-rays are sometimes required if there is doubt about the anatomical location of the pneumothorax. [16] [18]
The lung collapses, impairing normal breathing. Surrounding structures may also shift. When severe enough to cause these shifts and hypotension, it is called a tension pneumothorax. This is life-threatening. The increased pressure inside the chest can compress the heart and lead to a collapse of the blood vessels that drain to the heart.
Shock is the state of insufficient blood flow to the tissues of the body as a result of problems with the circulatory system.Initial symptoms of shock may include weakness, tachycardia, hyperventilation, sweating, anxiety, and increased thirst. [1]
Obstructive shock can occur in the setting of tension pneumothorax and cardiac tamponade. These etiologies should be uncovered in the primary survey. [ 3 ] In the setting of head or neck trauma, an inadequate sympathetic response, or neurogenic shock, is a type of distributive shock that is caused by a decrease in peripheral vascular resistance ...
Tension pneumothorax is the build-up of air into one of the pleural cavities, which causes a mediastinal shift. When this happens, the great vessels (particularly the superior vena cava ) become kinked, which limits blood return to the heart .
Left tension pneumothorax with a large, well-demarcated area devoid of lung markings with tracheal deviation and movement of the heart away from the affected side. Mediastinal shift is an abnormal movement of the mediastinal structures toward one side of the chest cavity .
In the emergency department the typical approach to chest pain involves ruling out the most dangerous causes: heart attack, pulmonary embolism, thoracic aortic dissection, esophageal rupture, tension pneumothorax, and cardiac tamponade. By elimination or confirmation of the most serious causes, a diagnosis of the origin of the pain may be made.
cardiac causes, pulmonary causes and; non-pulmonary and non-cardiac causes. Considered physiologically, pulsus paradoxus is caused by: [citation needed] decreased right heart functional reserve, e.g. myocardial infarction and tamponade, right ventricular inflow or outflow obstruction, e.g. superior vena cava obstruction and pulmonary embolism, and