Difference between Atelectasis and Pneumothorax

Updated on June 28, 2018

Atelectasis and pneumothorax are pulmonary conditions that require immediate treatment. While the two may bear similarities, they are completely different in several ways.

Summary Table

AtelectasisPneumothorax

There are two types according to cause: obstructive and non-obstructive atelectasis

There are two types according to cause: traumatic and non-traumatic pneumothorax

Caused by an obstruction or by pulmonary conditions such as pleural effusion, pneumothorax, lung scarring, or a surgical complicationCaused by an injury or other risk factors such as a chronic or acute lung infection, cystic fibrosis, or chronic obstructive pulmonary disease
Can be caused by pneumothoraxCannot be caused by atelectasis

Signs and symptoms:

Shortness of breath, tachycardia (increased heart rate), cyanosis (bluish discoloration of the skin, nail beds, and lips), persistent cough, and a sharp pain in the chest, especially when coughing

Signs and symptoms:

Shortness of breath, tachycardia (increased heart rate), cyanosis (bluish discoloration of the skin, nail beds, and lips), dry cough, sudden and steady chest pain, cold sweat, and a severe increase in heart rate

Can either be asymptomatic or symptomaticSymptomatic
Symptoms manifest depending on the rate of progression and severity of diseaseSymptoms can manifest shortly after the trauma

Treatment options: deep breathing exercises, chest physiotherapy, bronchoscopy, antibiotics, or surgery

Treatment options: needle or tube insertion or surgery

Complications: acute pneumonia, sepsis (infection), respiratory failure, and bronchiectasis (abnormal enlargement of the bronchi)

Complications: circulatory failure, respiratory failure, and shock

Recurrence rate is lower

Recurrence rate is higher

Definitions

atelectasis
A normal vs blocked bronchial tube, which is called atelectasis

Atelectasis, also called complete or partial lung collapse, is a pulmonary disorder caused by blockage or pressure buildup outside or inside the bronchial tubes of the lungs.

pneumothorax
A normal lung vs pneumothorax

Pneumothorax, on the other hand, is also known as lung collapse. It is characterized by the build-up of gas or air within the pleural space, which is the space that divides the chest wall and the lungs.

Atelectasis vs Pneumothorax

Learning the difference between atelectasis and pneumothorax can be a matter of life and death since both conditions require specific medical care and treatment. Although they are closely related terms, they are far from being alike.

Causes

Many predisposing factors are strongly linked to atelectasis and pneumothorax. To break down the causes, both conditions are divided into two major categories. The two types of atelectasis according to cause are obstructive and non-obstructive atelectasis. Obstructive atelectasis, as the name implies, is a condition where air cannot pass through the bronchial tubes due to mucus buildup, a tumor, a foreign object, or other types of obstruction. Non-obstructive atelectasis, by contrast, does not involve any blockage in the passageways. Instead, patients suffering from pulmonary conditions such as pleural effusion, pneumothorax, lung scarring, or a surgical complication are at risk for atelectasis.

Pneumothorax, by comparison, is divided into two major classifications: traumatic and non-traumatic pneumothorax. Traumatic pneumothorax is often caused by injuries obtained from medical procedures, contact sports, and vehicular accidents. Once the ribs or other structures in the chest cavity are damaged, air or gas can leak within the pleural space. Meanwhile, non-traumatic pneumothorax, also known as spontaneous pneumothorax, does not involve any trauma or injury. Instead, it is triggered by other risk factors such as a chronic or acute lung infection, cystic fibrosis, or chronic obstructive pulmonary disease. Simply put, while pneumothorax may heighten the risk for atelectasis, atelectasis is not a predisposing factor for pneumothorax.

Signs and Symptoms

Patients suffering from atelectasis and pneumothorax experience similar symptoms including shortness of breath, tachycardia (increased heart rate), and cyanosis (bluish discoloration of the skin, nail beds, and lips). However, despite their similarities, there are specific physical manifestations that draw the line between atelectasis and pneumothorax. Firstly, atelectasis can either be asymptomatic or symptomatic, depending on the severity and the rate of progression of the disease. Once the blockage becomes severe, patients may experience a range of symptoms including a persistent cough and sharp pain in the chest, especially when coughing.

The signs and symptoms associated with pneumothorax, on the other hand, can appear shortly after the trauma. Aside from shortness of breath, patients with pneumothorax experience a sudden and steady chest pain, which is accompanied by cold sweat and a severe increase in heart rate. Non-traumatic pneumothorax can also be manifested by a dry cough.

Treatment

Since they pose different pulmonary risks, the goals behind the treatment plan for atelectasis and pneumotherapy greatly differ. During the preliminary stages, patients diagnosed with atelectasis are advised to perform deep breathing exercises or engage in chest physiotherapy. Once blockage is present in the bronchial tubes, a procedure called bronchoscopy is carried out to clear the passageway and enable normal breathing. Atelectasis due to an infection or a tumor may also necessitate the use of antibiotics and surgical procedures such as radiotherapy and chemotherapy.

Pneumothorax requires a different treatment plan. Since the problem arises due to the presence of gas or air between the lungs and the chest wall, the objective behind the treatment is to enable lung re-expansion by minimizing lung pressure. If a large part of the lung is affected, the excess air is removed by the use of a needle or a tube. In severe cases where the tube does not successfully remove air within the pleural space, surgery is performed to allow the lungs to re-expand.

Complications

Patients diagnosed with atelectasis can experience a range of complications including acute pneumonia, sepsis (infection), respiratory failure, and bronchiectasis (abnormal enlargement of the bronchi). Meanwhile, pneumothorax increases one’s risk for circulatory failure, respiratory failure, and shock.

Recurrence

Between the two pulmonary conditions, the recurrence rate of atelectasis is lower as it is treated right away once given proper medical attention. Pneumothorax, by contrast, typically recurs after 1 to 2 years.

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