Tension pneumothorax and pneumomediastinum
Worsening shortness of breath.
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Portable chest x-ray with a large left-sided pneumothorax. The left lung is collapsed with a contralateral shift of the mediastinum and depressed ipsilateral hemidiaphragm consistent with tension pneumothorax. Air is also seen outlining the heart and thymus (spinnaker sign) representing pneumomediastinum. Minimal air is seen projecting within subcutaneous tissues along the left lateral chest wall suggestive of subcutaneous emphysema.
Tension pneumothorax is a medical emergency and requires immediate relieving of tension by inserting a cannula or a needle typically in 2nd intercostal space.