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Tension Pneumothorax

Here’s an example of a large, right-sided tension pneumothorax (PTX). Disruption in the lung leads to a one-way valve where air fills the pleural space and expands the PTX during inspiration but cannot escape during expiration.

The resulting accumulation of air precipitates hemodynamic collapse (mediastinal shift, venous compression, etc.) and requires decompression with a needle thoracostomy and/or chest tube placement to restore cardiac output. Notice how the right internal jugular central line (unrelated to the PTX) terminates near the cavoatrial junction which has been shifted leftward.

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