Watch out for chest pain in adolescents! It might be “pneumothorax”
Recently, a young man visited the Physical Examination Center of Taipei City Hospital for occupational physical examination. He mentioned that he experienced chest tightness and dyspnea on the stairs for two weeks. Since he rarely exercised and spent prolonged times playing video games and on phones, he figured that the discomfort was caused by the lack of exercise and poor circulation. X-ray examination at the hospital revealed left pneumothorax with localized lung collapse. He recovered after transferal and treatment.Dr. Cheng Chieh-Hao at the Family Medicine Division, Taipei City Hospital, Linsen Chinese Medicine and Kunming Branch, expressed that pneumothorax is the infiltration of air into the pleural cavity, causing difficulties in lung expansion. According to foreign statistics, the incidence of spontaneous pneumothorax is approximately 7 to 37 in 100,000, more common in males, adolescents around the age of 20 have the highest incidence rate, and the most important risk factor other than family history and genetic diseases is “smoking”. According to studies, smoking one pack a day will increase the incidence rate by 102 times in males and 68 times in females.
Spontaneous pneumothorax usually happens when patients are resting. They would feel sudden chest pain and dyspnea. Mild pneumothorax does not have obvious symptoms and will heal on its own. In severe cases where large amounts of gas collapse the lung, there is a risk of mortality. The clinical diagnostic methods are history taking, detailed physical examinations, and chest x-ray. In terms of treatment, the human body can self-absorb some gases, so mild cases of pneumothorax only require follow-ups and do not need further treatment. Admission is required for moderate and severe pneumothorax cases. Chest tubes are inserted for air decompression to prevent lung collapse and risk of mortality. Dr. Cheng expressed that the occurrence of spontaneous pneumothorax is unpredictable and most happen in adolescents. He advises adolescents to seek medical attention in the event of unidentified chest pains.