You don’t need a car crash, a fall or a hard hit to get a collapsed lung. It can happen out of nowhere, even if you feel healthy. Health care providers call this spontaneous pneumothorax. It can come on quickly and be frightening.
Here’s what causes a collapsed lung without injury, who is most at risk and the signs that it’s time to seek help.
What is a spontaneous pneumothorax?
A spontaneous pneumothorax (collapsed lung) happens when air leaks into the space between your lung and chest wall (the pleural space). Usually, this space is sealed but when air gets in, it pushes on your lung. This pressure keeps the lung from fully expanding, making it hard to breathe.
The condition is called pneumothorax. "Pneumo" means air and "thorax" means chest. So it literally means “air in the chest.”
A spontaneous pneumothorax can be small or large. A small one might improve without treatment but a larger one may need to be drained with a tube or even require surgery.
How can a collapsed lung happen without injury?
A lung can collapse even without injury due to small changes inside it.
“A tiny air pocket or bleb can suddenly burst, letting air slip between the chest wall and the lung,” said Stephanie Worrell, MD, a thoracic surgeon with Banner - University Medicine. “This can happen with high pressure, like coughing, or even at rest in some people.”
A bleb is a small blister filled with air on the surface of the lung. You might have one or more and not even notice. They can stay there quietly for years. One day, one of them might pop. When it bursts, air escapes and puts pressure on the lung, causing it to collapse.
There are two main types of spontaneous pneumothorax:
- Primary spontaneous pneumothorax: This type happens in people without known lung disease.
- Secondary spontaneous pneumothorax: This type occurs in people with underlying lung conditions, such as COPD, emphysema, asthma or cystic fibrosis. It tends to be more serious because the lungs are already weaker.
Who is most at risk?
A spontaneous lung collapse can happen to anyone. However, you may be more likely to develop this lung condition if you:
- Are tall and thin
- Are between the ages of 20 and 40
- Smoke or vape (smoking raises your risk)
- Have a family history of collapsed lung
- Have a chronic lung disease like COPD, emphysema, asthma or cystic fibrosis
- Have had a collapsed lung before
- Have a connective tissue disorder like Marfan syndrome
A sudden change in air pressure can also play a role. Flying, scuba diving or even a hard coughing fit can sometimes trigger a collapse.
What does a collapsed lung feel like?
A collapsed lung doesn’t always feel the same for everyone but there are some common signs.
“People often feel sudden, sharp chest pain and feel like they can’t catch their breath,” Dr. Worrell said. “In serious cases, blood flow to the heart can be blocked, leading to severe chest pain and even death."
It can be hard to tell a collapsed lung from a pulled muscle, heartburn or a panic attack. All of these conditions can cause chest pain and trouble breathing. But pain from a collapsed lung doesn't go away with rest.
If you're worried, it's safest to see a health care provider. A small collapse can become worse over time.
Call 911 or go to the nearest emergency room if you have:
- Severe chest pain that won’t go away
- Trouble breathing or feeling like you can’t catch your breath
- Bluish lips, face or fingernails
- A racing heart
- Feeling faint, dizzy or confused
How is a collapsed lung diagnosed?
A spontaneous pneumothorax is usually diagnosed with a chest X-ray. In some cases, a computerized tomography (CT) scan or ultrasound may be needed. These tests show whether air is trapped around the lung and how much of the lung has collapsed.
How is it treated?
Treatment depends on your symptoms, the size of the leak and whether it stops on its own. For a small pneumothorax, your provider might recommend rest, oxygen therapy and close monitoring.
If more of the lung is collapsed, more treatment may be needed. This may include:
- Needle aspiration: A small needle or tube through the chest wall to remove trapped air.
- Chest tube thoracostomy: A flexible tube is inserted between the ribs to drain air and help the lung expand.
- Chemical pleurodesis: A provider may use chemicals like doxycycline or talc to seal leaks. If an air leak doesn’t stop, surgery might be necessary.
- Surgery: Surgery is often done through video-assisted thoracoscopic surgery (VATS) to remove air pockets and seal leaks to prevent the lung from collapsing again.
Most of the time, a collapsed lung can heal within a few days to a couple of weeks. Your health care provider will let you know when it’s safe to get back to work, exercise and your normal routine.
Learn more about the treatment for a collapsed lung.
Can a collapsed lung happen again?
Yes. Once you’ve had a spontaneous pneumothorax, your risk of having another one increases. Your risk can be as high as 30% or more, especially within the first year.
To lower your risk:
- Avoid smoking or vaping
- Stay away from secondhand smoke
- Follow your provider’s advice
- Avoid certain activities that put pressure on our lungs (flying, scuba diving)
- Manage any lung conditions you have
- Keep follow-up appointments
Bottom line
A collapsed lung can happen without injury and often without warning. While that can be scary, knowing the signs can help you act quickly. Sudden chest pain and shortness of breath should never be ignored. Get medical help right away.
Most people get better with quick treatment. If something doesn’t feel right, trust your instincts and get checked. It’s always better to be safe when it comes to your breathing.
Frequently asked questions
Can a collapsed lung happen without injury?
Yes. A lung can collapse without trauma. This is called a spontaneous pneumothorax. It often happens when a small air pocket (bleb) in the lung bursts, allowing air to leak into the space around the lung.
What does a collapsed lung feel like?
A collapsed lung often causes sudden, sharp chest pain on one side. You may also feel short of breath or as if you can’t catch your breath. The pain usually does not improve with rest.
Is a collapsed lung life-threatening?
It can be. A small collapse may not be dangerous but a large one can put pressure on your heart and other organs. That’s why it’s important to get help right away if you have severe chest pain or trouble breathing.
Can you exercise after a collapsed lung?
Yes but not right away. Your provider will let you know when it’s safe to resume activity. You’ll likely need to avoid heavy lifting, intense workouts and contact sports for several weeks. Scuba diving may be off-limits for life.
Can you fly after having a collapsed lung?
Not right away. Changes in air pressure on a plane can be risky for a healing lung. Most health care providers recommend waiting at least a few weeks before flying. Always check with your provider before booking a trip.
Can I prevent a collapsed lung?
Not always but avoiding smoking and vaping can reduce your risk. Stay away from secondhand smoke and manage any lung conditions you have.
