Lung and chest conditions

Asthma is a chronic, or long-term, lung disease. If you have asthma your lung airways are inflamed and narrow. Once triggered by exposure to an allergen, like pollen, animal dander or smoke, they become even more inflamed and narrow further. This makes breathing very difficult.

Pneumothoraxis, or collapsed lung, is a condition in which air in the lungs leaks into the chest cavity. This is a common complication of blunt trauma to the chest, often sustained from a fractured rib. Sometimes people can have a collapsed lung without rib fractures, when the force of the impact on the chest forces air out of the lung.

Learn more about care for collapsed lungs.

Chronic Obstructive Pulmonary Disease (COPD) is a term used to describe a number of progressive lung diseases. These diseases are chronic, long lasting, and inflame the lung tissue. This causes the airflow to and from the lungs to be obstructed. These conditions include:

• Chronic bronchitis
• Emphysema
• Refractory (non-reversible) asthma
• Some forms of bronchiectasis

This disease is characterized by increasing breathlessness, coughing, mucus production and wheezing sounds while breathing.

Chest injuries can cause a hemothorax, which is accumulation of blood in the chest cavity. Blood in your chest cavity results from injury to:

• Lung tissue
• Blood vessels that run alongside each rib
• The heart
• Major blood vessels around the heart.

Your physician will diagnose your condition using a chest x-ray, an ultrasound or a CT scan.

Treatment of Hemothorax

We may recommend observation if you have a clinically insignificant amount of blood. If your hemothorax is large or causing symptoms, your doctor will need to remove the collected blood. He or she can do this in different ways.

Chest tube

A chest tube treatement involves having your doctor make a small hole between your ribs. He or she will put a chest tube through the hole and into the collection of blood or fluid in the chest. The chest tube will stay in your chest for a few days, or more, until the drainage from the tube slows down. Before we remove your chest tube, we make sure the blood is gone using an x-ray and physical examination. You will need to stay in the hospital while this tube is in your chest.

Surgery for Hemothorax

Sometimes you need surgery to remove the blood from the chest cavity. We do this if the blood was not drained with the chest tube alone. If the blood has been in the chest for several days, it can become very thick. To remove it, your doctor needs to be more invasive.

We call the surgery to remove blood from your chest a thoracoscopy or VATS (Video-assisted Thoracic Surgery). You will be under under general anesthesia for your procedure. Your doctor makes 2 or 3 small cuts between the ribs in your chest. He or she will put long, thin tools in these openings and into the space where the air collected. One of the tools has a camera on the end, which sends pictures to a TV screen. The doctor can look at the image on the screen to do your surgery.

If your doctor feels we cannot clear your hemothorax using minimally invasive surgery, he or she will recommend a different service. This may be a thoracotomy, or open chest surgery.

After surgery you will have one or more chest tubes placed to continue draining the fluid and blood from your chest. You will need to stay in the hospital for 3-7 days, or more, as you recover. Your chest tube remains in your chest, and is removed only after we confirm your healing as expected. Confirmation of healing involves an examination by your doctor and a chest x-ray.

An infection of your chest, or empyema, occurs when there is a build-up of infected fluid between your lungs and your rib cage. This build up of fluid is usually caused by pneumonia, an infection of the lung. The fluid builds up in the space outside the lung, due to lung inflammation. This external pulmonary fluid can become infected. If it becomes very thick, the body cannot get rid of it on its own.

Treating your infection

Treatment of this condition requires hospitalization. Most often we can treat you with IV (intravenous) antibiotics and drain the fluid in your chest cavity. To drain this fluid, we place a chest tube between your ribs, into the space between the lungs and the chest wall. You will remain in the hospital while the tube is in your chest.

Chronic empyema, or reoccuring, requires surgery to clean out the infected fluid. Your surgery will most likely be a thoracoscopy where we use a scope inside your chest for viewing. Your doctor might decide your condition needs video-assisted thoracic surgery (VATS) instead. VATS is a “minimially invasive” surgery of the chest.

You will be under under general anesthesia for your procedure. Your doctor makes 2 or 3 small cuts between the ribs in your chest. He or she will put long, thin tools in these openings and into the space where the air collected. One of the tools has a camera on the end, which sends pictures to a TV screen. The doctor can look at the image on the screen to do your surgery.

If your doctor feels we cannot clear your empyema minimally invasive surgery, he or she will recommend a different service. This may be a thoractomoty, or open chest surgery.

Learn more about our surgery services.

Cancers of the thoracic (chest) region, include lung, esophageal, thymus and mesothelioma. Lung cancer is the most common however. In the early stages, these cancers may not exhibit any symptoms. Because these diseases are challenging to treat, it’s important to visit your doctor for regular exams as part of your preventive healthcare. You should share any concerns, no matter how small they seem, at these visits. This is especially true if you have a history of smoking or other high-risk health or family history.

Learn more about lung cancer.

Pulmonary contusion, or a bruise of the lung , is another common consequence of blunt chest trauma. Pulmonary contusions generally develop 24-48 hours after your accident. They show up as an abnormal area of the lung on chest x-ray or CT scan.

Like any bruise, they take about one week to heal.

Treating your bruise

Treatment of a bruised lung involves treating your pain and discomfort. Pain management will allow you to take deep breaths and cough. Treating your pain is important. When you have rib pain, you try to keep your ribs from moving too much. This ofen results in you not breathing in and out as deeply as you should. When you don't inflate your lungs fully, some of the small airways in the lungs close off. This raises the chances of getting a lung infection, called pneumonia.

Hospitalization

If you have many rib fractures and lung contusion we may hospitalize you for 2-7 days or more. This time will allow you to adequately recovery and be closely observed by your doctor.

Your doctor will also recommend a treatment to help prevent your small airways from closing off. This treatment, called “incentive spirometry,” involves breathing deeply into a hand-held device many times each day.

It is also very important that you stay active. Activity, like walking, although painful, is very important to keep good lung function. It also works to prevent pneumonia. Once you go home from the hospital, you should walk around your house several times per day. Increase your activity as you can tolerate.

If you have severe or numerous rib fractures, with severe pulmonary bruising, you may not be able to breathe on your own. To sustain you body’s oxygen needs, we may place you on a ventilator, to help you breath.

Pulmonary hypertension (PH) is high blood pressure in the arteries to your lungs. It makes the right side of the heart work harder than normal. Over time, your heart weakens and cannot do its job and you can develop heart failure. is high blood pressure in the arteries to your lungs. This high pressure makes the right side of your heart work harder than normal. Over time, your heart weakens and cannot do its job effectively.

Learn more about pulmonary hypertension (PH) and how we can help.

A rib fracture injury occurs when one of the bones, or cartilage, in the rib cage cracks. The most common cause of a fractured rib is a blow to the chest, often from a car accident or a fall. Coughing hard can also fracture a rib.

Learn more about rib fractures.

Sternal fractures or fracture of the breast bone usually results from a direct blow to the front of the chest. Typically these fractures occur during a motor vehicle crash. Either your chest strikes the steering column or the rapid stop causes your chest to slam against the cross-shoulder seatbelt. Common associated injuries include:

• Blood in the chest (hemothorax)
• Brusing of the heart (myocardial contusion)
• Collapsed lung (pneumothorax)
• Rib fractures
• Spinal fracture

Treatment for your fracture

No specific treatment is usually needed. Pain control is very important to prevent pneumonia. When you have this sort of chest pain, you try to keep your ribs from moving too much. This often results in you not breathing in and out as deeply as you should. When you don't inflate your lungs fully, some of the small airways in the lungs close off. This raises the chances of getting a lung infection, called pneumonia.

Your doctor will also recommend a treatment to help prevent your small airways from closing off. This treatment, called “incentive spirometry,” involves breathing deeply into a hand-held device many times each day.

It is also very important that you stay active. Activity, like walking, although painful, is very important to keep good lung function. It also works to prevent pneumonia. Once you go home from the hospital, you should walk around your house several times per day. Increase your activity as you can tolerate.