Hemothorax (patient information)

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 * Associate Editor-In-Chief: Mohammed A. Sbeih, M.D. [mailto:msbeih@perfuse.org]

Overview
Hemothorax is a collection of blood in the space between the chest wall and the lung (the pleural cavity).

What are the symptoms of Hemothorax?

 * Anxiety.
 * Chest pain.
 * Low blood pressure.
 * Pale, cool and clammy skin.
 * Rapid heart rate.
 * Rapid, shallow breathing.
 * Restlessness.
 * Shortness of breath.

What causes Hemothorax?
The most common cause of hemothorax is chest trauma. It can also occur in patients who have:


 * A defect of blood clotting.
 * Death of lung tissue (pulmonary infarction).
 * Lung or pleural cancer.
 * Placement of a central venous catheter.
 * Thoracic or heart surgery.
 * Tuberculosis.

When to seek urgent medical care?
Call 911 if you have:

Go to the emergency room or call the local emergency number (such as 911) if you have:
 * Any serious injury to the chest.
 * Chest pain or shortness of breath.


 * Dizziness, fever, or a feeling of heaviness in your chest.
 * Severe chest pain.
 * Severe difficulty breathing.

Diagnosis
Your doctor may note decreased or absent breath sounds on the affected side. Signs of hemothorax may be seen on the following tests:
 * Chest x-ray.
 * CT scan.
 * Pleural fluid analysis.
 * Thoracentesis.

Treatment options
The goal of treatment is to get the patient stable, stop the bleeding, and remove the blood and air in the pleural space. A chest tube is inserted through the chest wall to drain the blood and air. It is left in place for several days to re-expand the lung. When a hemothorax is severe and a chest tube alone does not control the bleeding, surgery (thoracotomy) may be needed to stop the bleeding. The cause of the hemothorax should be also treated. In people who have had an injury, chest tube drainage is often all that is needed. Surgery is often not needed.

Where to find medical care for Hemothorax?
Directions to Hospitals Treating Hemothorax

What to expect (Outlook/Prognosis)?
The outcome depends on the cause of the hemothorax and how quickly treatment is given.

Possible complications

 * Collapsed lung, leading to respiratory failure.
 * Death.
 * Empyema.
 * Fibrosis or scarring of the pleural membranes.
 * Pneumothorax.
 * Shock.

Prevention
Use safety measures (such as seat belts) to avoid injury. Depending on the cause, a hemothorax may not be preventable.