Spontaneous pneumothorax in older people may arise from a number of causes which produce localised areas of emphysema or dilation of the airsacs. Rupture occurs spontaneously and is not related to straining at work or sport.
There is a sudden onset of chest pain, usually made worse by breathing, associated with shortness of breath. The symptoms are marked and often distress the victim so much he is convinced he has suffered a heart attack.
Examination by the doctor should provide the correct diagnosis and could be confirmed by an X-ray of the chest.
Small pneumothoraces may be left to resorb the air and allow the lung to re-expand. Larger ones will require drainage of the air.
As the person breathes and coughs, the air is forced down the tube and bubbles out through the water, but the water rises in the tube and prevents more air from entering the pleural space.
In recurrent cases of spontaneous pneumothorax, it may be necessary to obliterate the pleural space to prevent recurrence.
This can be achieved by operation or instilling irritants into the pleural cavity to cause inflammation of the surfaces of the pleura so that they stick together.
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