Every week Edwin de Vaal (47), general practitioner in Nijmegen, answers a frequently asked or striking question from his practice. This week: "Does pain on breathing mean that I have a blow?"
Does painful breathing always indicate a collapse?
"No, not always. Often the pain in the inhalation and the stretching of the chest is caused by a muscle tear, a pinched nerve or a bruise. The doctor can find this out by listening to your lungs and examining your chest."
See also: Research: Lungs of former smokers recover better than expected
What is a collapse long?
"The lung is a very soft spongy fabric that has a membrane over it. There is also a membrane on the inside of the chest and these membranes are vacuum-glued together. You can compare the mechanism with a suction cup that you put on a window or cupboard door. "
"If a leak occurs in the membrane, air comes between the lung and pleura and the vacuum disappears, part of the lung then collapses literally. Because no fresh air enters the lung, you get stuffy. And the pain is caused by the pulmonary membranes now scraping over each other instead of sliding. You only experience that pain when you breathe in and out. "
How does a folding lung arise?
"A collapsing lung can occur spontaneously. This is relatively common in young tall men, especially if they also smoke. We do not yet know exactly why that is. It can also be caused by an accident, for example if someone in an accident rib breaks and thus punctures the peritoneum. "
"Divers sometimes suffer from it too. This is due to the pressure differences under water. Large pressure differences can also cause a collapse in the aircraft. Furthermore, smoking gives a higher risk. And also lung diseases such as COPD, emphysema and lung cancer."
How do you make the diagnosis?
"First I tap the chest on the front and the back. With a collapsing lung, the part where the lung is collapsed sounds louder than elsewhere. I also listen with a stethoscope to see if I can hear the breathing. With a collapsing lung you don't hear it, because the lung can no longer fill with air. Furthermore, you often see that the oxygen content is lowered and the heart rate is increased. When in doubt, but also for confirmation, I send patients for a lung photo. "
Can a blow-on lung be treated properly?
"If the lung is only slightly collapsed, it usually goes away by itself if you take it easy. The hole recovers automatically within a few weeks and the lung then unfolds again. Is it really a 'big blow'? "Then they can suck out the air in the hospital with a hollow needle and restore the vacuum. That may seem like a major intervention, but that is not so bad."
Every week GP De Vaal answers a frequently asked or striking question from his practice at NU.nl.
Do you also have a question for our doctor?
Send your question to the editors: email@example.com