A Deeper Look At Hemothorax And Its Causes

Our lungs – two spongy air sacs that help us breathe – sit in a protective cage formed by our ribs. A thin space around separates the lungs from the ribs. This space – called the pleural space – makes room to allow smooth movement as we breathe.

But what happens when that space gets filled with something it shouldn’t—like blood? This condition is called hemothorax. When blood collects in the pleural space, it can obstruct normal breathing, leading to a host of health issues.

But how does blood find its way into your pleural space in the first place? That’s an interesting question that we’ll attempt to answer in our blog today. Let’s get started.

Causes of Hemothorax

Hemothorax is undoubtedly a deadly condition, much like any other lung condition. This is primarily because any problem surrounding our lungs can impact our breathing directly, which is our primary life force in a way. 

Learning about how such a condition comes to be is essential. Below, we’ll explore several causes behind it, from the most common to the rarest ones.

Thoracic Injuries or Trauma 

Thoracic injuries or trauma refer to any damage to the chest area, which includes the ribs, lungs, heart, and major blood vessels. The MSD Manual notes that thoracic trauma contributes to over 25% of total physical trauma-related deaths in the US. In fact, in most cases of chest injury, one can lose their life within the first few minutes or hours.

These injuries can happen in various ways – think of car accidents, falls, or sports-related impacts. 

A severe blow to the chest can break ribs or damage the blood vessels surrounding the lungs. When this happens, blood may leak into the space around the lungs, leading to hemothorax.

Imagine the chest cavity as a room where the lungs need space to move freely with each breath. Now, picture that room suddenly filling with liquid – there’s less room for the lungs to expand, making it harder to breathe. That’s what hemothorax does, and it can become life-threatening if not treated promptly.

Preventing hemothorax from thoracic injuries isn’t always possible, especially in accidents. That being said, safety measures can certainly make a difference. By wearing seat belts in cars, using protective sports gear, and following safety guidelines when working at heights, you can minimize their risk.

Cancer

Considering cancer’s lethal nature, it’s not surprising to learn about the link between cancer and hemothorax. But are you at the risk of hemothorax if you’re battling any kind of cancer? Not really. 

Hemothorax can only be triggered by cancer in or around our chest cavity – including lung cancer and pleural mesothelioma. The former is the more common one, starting in the lung cells. Over time, it can even grow into nearby tissues, sometimes causing bleeding into the chest cavity.

Pleural mesothelioma, on the other hand, is rarer. According to the Cleveland Clinic, it affects the lining of the lungs (pleura) and is often linked to asbestos exposure. It is categorized into three types, based on the kind of mesolithial cells where cancer develops – Epitheliod, Sarcomatoid, and Biphasic mesothelioma.

Much like lung cancer, pleural mesothelioma can also invade the chest wall or blood vessels, leading to bleeding. When these cancers grow, they can damage blood vessels in the chest. If a tumor breaks through a vessel wall, it can cause blood to spill into the space around the lungs. This accumulation of blood creates pressure, limiting the lungs’ ability to expand.

For patients already struggling with cancer, the added burden of hemothorax can make breathing even more challenging, impacting their overall quality of life.

A Misplaced Catheter

A catheter is a thin, flexible tube inserted into the body to help with medical treatments, like delivering medication or draining fluids. Doctors often use catheters to access large veins near the heart, especially in critical care settings. While generally safe, the problem arises when a catheter is accidentally placed in the wrong spot.

When a catheter punctures a blood vessel near the lungs, it causes bleeding into the chest cavity – resulting in hemothorax. Besides the misplacement of catheters, the fracture of these medical devices when installed inside your body is equally dangerous.

TorHoerman Law notes that a catheter fracture or failure exposes patients to severe health complications. Apart from hemothorax, it also increases the likelihood of deep vein thrombosis (DVT), pulmonary embolism, tachycardia, arterial puncture, and more.

Bard PowerPort is an example of a catheter device brand whose products have failed in many patients. In light of the complications and injuries they’ve suffered, they’ve filed a Bard PowerPort lawsuit against their manufacturers. As of this month, 427 cases have been registered in the lawsuit. 

Blood Clotting Disorders 

Blood clotting disorders are conditions that affect the body’s ability to form clots. Clotting is a natural process that stops bleeding when you get injured. However, when this process is disrupted, it can lead to excessive bleeding or unwanted clots. 

Common clotting disorders include hemophilia, which prevents blood from clotting properly, and thrombocytopenia, where the body doesn’t have enough platelets to form clots. The symptoms of these disorders include easy bruising, frequent nose bleed, chest pain, and shortness of breath, notes the American Society of Hematology.

But how do these disorders relate to hemothorax? When blood vessels in the chest area are damaged – due to injury – clotting disorders can make it difficult to stop the bleeding. As a result, blood accumulates in the pleural space, leading to hemothorax. 

For people living with clotting disorders, even minor chest trauma can trigger significant internal bleeding, making them more susceptible to this condition.

Frequently Asked Questions (FAQs)

How is hemothorax diagnosed?

Diagnosis of hemothorax starts with a physical exam; doctors listen for muffled lung sounds that hint something’s amiss. Then, imaging comes into play – chest X-rays or CT scans are the go-to tools. They reveal the telltale signs of blood in your chest cavity.

How is pneumothorax different from hemothorax?

Both pneumothorax and hemothorax are conditions involving the pleural space around our lungs. However, the cause of disturbance in the space varies in both cases. Cleveland Clinic notes that in pneumothorax, air fills it up, pressing it against your chest, as opposed to blood in the case of hemothorax.

Can a thoracostomy tube help treat hemothorax?

A thoracostomy tube – also referred to as a chest tube – is a flexible tube inserted into your chest cavity. By exerting negative pressure in the cavity, it helps remove any blood deposited in the pleural space. Medscape notes that thoracostomy tube drainage treats hemothorax successfully in 70-80% of the cases. 

Hemothorax may sound intimidating, but understanding its causes can help you recognize the risks and take preventive measures. Whether it’s trauma, cancer, a misplaced catheter, or blood clotting disorders – knowing the cause empowers you to take charge of your health.