Chest Pain Cause Cardiopulmonary Hemothorax

Hemothorax occurs when blood collects in the pleural cavity (the space between the lungs and the chest wall). One of the more common causes of chest pain, hemothorax is often seen in combination with pneumothorax, a condition that is more commonly known as a collapsed lung.

Although it is one of the most common causes of chest pain, incidence rates of hemothorax are difficult to determine. Mild cases of hemothorax cause few symptoms and minimal chest pain that may not require treatment. It’s quite possible for a person to develop and heal a mild case of hemothorax without being aware of its presence.

Based on rates of trauma nationwide, an estimated 300,000 cases of hemothorax are treated every year in the United States.

Hemothorax Causes

The most common causes of chest pain related to hemothorax are blunt and penetrating trauma:

  • Blunt trauma can result in broken ribs that slice into lung tissue and cause bleeding. Falls, car accidents and contact sports injuries can all cause blunt trauma.
  • Penetrating trauma describes such injuries as knife wounds, gunshot wounds or wounds caused by other sharp objects. Penetrating trauma can cut into the lung tissue, causing bleeding and hemothorax.

In addition to trauma, hemothorax can be caused by a variety of medical conditions and medical procedure complications. Chest surgery (a.k.a., thoracic surgery) and heart surgery often result in hemothorax.

Other hemothorax causes include:

  • lung cancer
  • pleural cancer (cancer of the pleura, the membranous sacs that cover the lungs)
  • pulmonary embolism (a condition in which a blood clot becomes lodged in a blood vessel in the lungs)
  • tuberculosis complications.

Bleeding disorders and blood-thinning medications are also possible hemothorax causes, as are medications that dissolve blood clots.

Hemothorax Symptoms

Hemothorax symptoms vary in intensity depending on both hemothorax cause and the volume of blood in the chest cavity. Very mild trauma resulting in minimal bleeding may produce few or no hemothorax symptoms. In contrast, severe hemothorax can cause intense chest pain and shock.

Common hemothorax symptoms include:

  • anxiety
  • respiratory failure
  • restlessness
  • shortness of breath
  • tachycardia (rapid heart rate)
  • varying degrees of chest pain.

When hemothorax presents with pneumothorax (collapsed lung), symptoms may be severe.

Hemothorax Treatment

Hemothorax treatment varies depending on hemothorax causes. In general, initial hemothorax treatment focuses on stabilizing the patient, locating the source of chest cavity bleeding and stopping the bleeding.

Hemothorax treatment also aims to drain existing blood out of the pleural cavity. A chest tube is inserted between the ribs into the chest cavity, and a suction device is attached to the tube to draw out the blood.

If a collapsed lung is a factor, the chest tube may remain in place for several days, providing continuous suction to remove air and blood while giving the collapsed lung enough time to re-expand.

Resources

Mancini, M. (updated June 28, 2006). Hemothorax. Retrieved November 7, 2007, from the eMedicine Web site: www.emedicine.com/med/topic2915.htm.

National Library of Medicine. (updated October 16, 2006). Hemothorax. Retrieved November 7, 2007, from the MedlinePlus Web site: www.nlm.nih.gov/medlineplus/ency/article/000126.htm.

Society of Critical Care Medicine. (n.d.). Hemothorax. Retrieved November 7, 2007, from the ICU-USA Web site: www.icu-usa.com/tour/medical_conditions/htx.htm.