Most people recover fully. Complicated spontaneous pneumothorax occurs in people with extensive lung disease. This type of pneumothorax most often results from the rupture of a bulla in older people who have emphysema. Complicated spontaneous pneumothorax may also occur in people with other lung conditions, such as cystic fibrosis, eosinophilic granuloma, lung abscess, tuberculosis, and Pneumocystis carinii pneumonia. Because of the underlying lung disease, the symptoms and outcome are generally worse in complicated spontaneous pneumothorax.
Tension pneumothorax is a serious and potentially life-threatening form of pneumothorax.
In this condition, the tissues surrounding the area where air is entering the pleural space act as a one-way valve, allowing air to enter but not to escape. This situation causes such high pressure in the pleural cavity that the lung completely collapses, and the heart and other mediastinal structures are pushed over to the opposite side of the chest. If not relieved quickly, tension pneumothorax can cause death in minutes. Symptoms and Diagnosis Symptoms vary greatly depending on how much air enters the pleural space and how much of the lung collapses. They range from a little shortness of breath or chest pain to severe shortness of breath, shock, and life-threatening cardiac arrest.