What is Hemothorax

Hemothorax is a buildup of blood in the space between the lungs and the chest wall (pleural cavity). This can cause trouble breathing, a collapsed lung (pneumothorax), and other dangerous problems.

This condition is a medical emergency that must be treated right away in a hospital.

What are the causes?

This condition is most often caused by an injury (trauma) that causes a tear in a lung or in a blood vessel in the chest. Other possible causes include:

• Tuberculosis.
• An injury caused by placing a tube into a blood vessel in the chest (central venous catheter).
• Cancer in the chest.
• A problem with how your blood clots.
• Blood thinner (anticoagulant) medicines.
• Lung surgery or heart surgery.

What are the signs or symptoms?

Signs and symptoms may include:

• Rapid breathing.
• Difficulty breathing.
• Shortness of breath.
• Feeling light-headed.
• Anxiety.
• Restlessness.
• A rapid heart rate.
• Low blood pressure (hypotension).
• Chest pain.
• Skin that is cool, sweaty, pale, or blue.

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms and medical history. Your health care provider may ask about any recent injuries you have had.
• A physical exam.
• A chest X-ray.
• Removal and testing of a blood sample from the pleural cavity.

How is this treated?

This condition must be treated at the hospital. Treatment may include:

• A procedure to place a small tube into the pleural cavity (chest tube). The chest tube drains fluid, blood, and extra air. It can also be used to expand a pneumothorax, if needed.
• Surgery to open the chest and control bleeding (thoracotomy). You may need surgery if bleeding continues after you have a chest tube placed.
• IV fluids.
• Blood transfusion. You may receive:
  • Your own blood that is collected from a chest drainage device and infused back into your body (autotransfusion).
  • Blood from a donor (blood transfusion).

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not drive or use heavy machinery while taking prescription pain medicine.

General instructions

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• If a cough or pain makes it difficult for you to sleep at night, try sleeping in a semi-upright position in a recliner or by using 2 or 3 pillows.
• If you were given an incentive spirometer, use it every 1–2 hours while you are awake or as recommended by your health care provider. This device measures how well you are filling your lungs with each breath.
• If you had a chest tube and it was removed, ask your health care provider when you can remove the bandage (dressing). While the dressing is in place, do not allow it to get wet.
• Keep all follow-up visits as told by your health care provider. This is important.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.

Contact a health care provider if:

• Your pain is not controlled with the medicines you were prescribed.
• You were treated with a chest tube, and you have redness, increasing pain, or discharge at the site where it was placed.
• You have a fever.

Get help right away if:

• You have difficulty breathing.
• You begin coughing up blood.
• You have chest pain.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

• Hemothorax is a buildup of blood in the space between the lungs and the chest wall (pleural cavity).
• This condition is a medical emergency that must be treated in a hospital right away.
• Hemothorax is most often caused by an injury (trauma) that causes a tear in a lung or in a blood vessel in the chest. Other possible causes include tuberculosis, cancer, blood thinner (anticoagulant) medicines, lung or heart surgery, or a problem with how your blood clots.
• Treatment includes receiving donated blood (blood transfusion) and having a small tube placed in the pleural cavity (chest tube). The tube can help drain blood, fluid, and extra air. It can also be used to expand a collapsed lung (pneumothorax).
• In some cases, surgery is needed to stop the bleeding.