Case 5

A 25 year old woman presents to the ED with abrupt onset of severe right sided pleuritic chest pain and some mild shortness of breath which settled after analgesia. She has no past medical or surgical history, is on no medications and has no allergies.

Her oxygen saturation was 98% on room air, her HR was 89, RR 22, she was apyrexic and had a normal blood pressure. Breath sounds are heard throughout both lungs but she is hyper-resonant on the right hand side.

Her chest x-ray is shown below.

pneumothorax 27mm at hilum.png

Question 1

What is the diagnosis?

Questions 2

How would you manage this patient?

Question 3

What other questions should you ask her in her history?

Question 4

How would you advise this patient when she is due for discharge from hospital?