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Left-sided tension pneumothorax. Note the area without lung markings which is air in the pleural space. Also note the tracheal and mediastinal shift from the patient's left to right. Causes include any obstruction of blood flow to and from the heart. There are multiple, including pulmonary embolism, cardiac tamponade, and tension pneumothorax.
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.
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]
This increased pressure reduces venous return, thereby reducing lung-heart function, resulting in signs and symptoms of shock. [15] Many of the signs of obstructive shock are similar to cardiogenic shock, although treatments differ. Symptoms of obstructive shock include: Abnormal heart rhythms, often a fast heart rate. Reduced blood pressure.
Rapid onset cardiac tamponade may also appear similar to pleural effusions, obstructive shock, shock, pulmonary embolism, and tension pneumothorax. [13] [10] If symptoms appeared more gradually, the differential diagnosis includes acute heart failure. [25] In a person with trauma presenting with pulseless electrical activity in the absence of ...
Image shows early occurrence of tracheal deviation. Tracheal deviation is a clinical sign that results from unequal intrathoracic pressure within the chest cavity.It is most commonly associated with traumatic pneumothorax, but can be caused by a number of both acute and chronic health issues, such as pneumonectomy, atelectasis, pleural effusion, fibrothorax (pleural fibrosis), or some cancers ...
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 .
lung injury of acute onset, within 1 week of an apparent clinical insult and with the progression of respiratory symptoms; bilateral opacities on chest imaging (chest radiograph or CT) not explained by other lung pathology (e.g. effusion, lobar/lung collapse, or nodules) respiratory failure not explained by heart failure or volume overload ...
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