Which statement best describes a simple pneumothorax?

• A. It presents with pleuritic chest pain, dyspnea, and decreased breath sounds on the affected side
• B. It presents with tracheal deviation
• C. It presents with JVD and hypotension
• D. It presents with fever and cough

Answer: (A)

A simple pneumothorax happens when air enters the pleural space and causes partial collapse of the lung without shifting the mediastinum or causing hemodynamic instability. The most consistent presentation is sudden pleuritic chest pain with shortness of breath, and on exam you typically hear decreased breath sounds on the affected side. You may also find hyperresonant percussion and reduced fremitus on that side. The absence of tracheal deviation or signs of poor blood flow helps distinguish it from a tension pneumothorax, which can cause tracheal shift, neck vein distension, and hypotension. Fever and cough point toward infection rather than a pneumothorax. So the statement describing pleuritic chest pain, dyspnea, and decreased breath sounds on the affected side best fits a simple pneumothorax.