A hemothorax is a medical condition in which blood fills the cavity which surrounds the lungs, leading to a decrease in lung function. If the condition is not treated, it is possible for the patient to die as a result of inhibited lung or heart function, or simply from severe blood loss. Patients most commonly develop a hemothorax after severe trauma to the chest, including puncture wounds which rupture the membranes which surround the lungs.
In normal circumstances, the pleural cavity which surrounds the lungs has a small amount of fluid to contribute to lubrication and decrease surface tension. When the lungs inflate with a breath, they fill the cavity, before partially deflating when the person exhales. In a hemothorax, the cavity fills with blood, making it impossible for the lungs to inflate fully, and in some cases, a lung may actually collapse from the pressure. The pressure of the fluid can also inhibit the function of the heart.
Patients with a hemothorax classically experience severe difficulty breathing. If their lungs collapse, they can develop an abnormal heart rhythm, paired with a paleness of the mucosa around the eyes and mouth, along with a pallor in the skin. In these cases, the patient's condition is critical and it needs to be addressed quickly, or the patient could die. In a less severe hemothorax, the condition can still cause a number of complications.
The primary treatment for a hemothorax is insertion of a chest tube, which will allow the blood to drain. Anticlotting agents may also be administered to keep the blood in the chest cavity from clotting up. The source of the bleeding also needs to be identified and stopped, and the patient may require a blood transfusion, as the blood loss involved can be considerable. A single pleural cavity can hold up to 40% of the body's total blood volume.
A few medical conditions are associated with spontaneous hemothorax, in which no obvious source of trauma causes the buildup of blood around the lungs. People who are at risk for this unusual form of the hemothorax are usually warned about it by their doctors, so that they know to seek prompt medical attention if they experience difficulty breathing. In any situation where someone is struggling to breathe, even if there is no obvious cause, it is critical to call emergency services as quickly as possible, because people can die very rapidly when they are unable to breathe, or they may develop complications such as brain damage as a result of oxygen deprivation.