Author: Jasreen Dhother, Riad Hosein / Editor: Nick Tilbury / Codes: ResC8, ResC9, SLO2, SLO3, SLO6 / Published: 08/09/2023

A 32-year-old female presents to the Emergency Department (ED) with a four day history of pleuritic chest pain and progressive shortness of breath (SOB) at rest.

The patient has recently returned to the UK from a long haul flight. She is an ex-smoker but currently vapes every day. She has no other past medical history of note and is on no regular medication.

Observations are as follows:

  • Respiratory rate: 22 breaths per minute
  • SpO2: 94% on room air
  • Blood pressure:125/85
  • Heart rate: 120 beats per minute

On examination, she is able to speak in full sentences. Auscultation reveals good air entry of the left lung, but absent breath sounds in all lung fields of the right lung. ECG shows sinus tachycardia.

An urgent PA chest radiograph shows a right sided spontaneous pneumothorax: