There must be a one-way valve mechanism causing more air to enter the pleural space on inspiration than exits on expiration. This collapses the ipsilateral lung and shifts the mediastinum away from the side of the pneumothorax.
Tension pneumothorax can be caused by trauma or infection, which perforates the lung, leading to a one-way flap.
Decreased breath sounds are heard due to presence of air in the pleural space.
Due to buildup of pressure on the ipsilateral side of the tension pneumothorax, it may cause the mediastinum and trachea to deviate away from the affected side.
Chest pain is present in tension pneumothorax.
Marked tachycardia is present in tension pneumothorax.
Rapid labored respirations are present in tension pneumothorax.
Tension pneumothorax can cause increased pressure within the chest vacuity and thus reduce systemic venous return to the heart leading to reduced cardiac output and hypotension.
Ventilation-perfusion mismatch can lead to decreased PaO2.
Increased intrapleural pressure can lead to hyperresonance on percussion.
Tension pneumothorax presents with a sudden deterioration of the patient and is a medical emergency.
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