Cancer Lung Cancer Symptoms What Is Atelectasis? By Lynne Eldridge, MD facebook Lynne Eldrige, MD, is a lung cancer physician, patient advocate, and award-winning author of "Avoiding Cancer One Day at a Time." Learn about our editorial process Lynne Eldridge, MD Medically reviewed by Medically reviewed by Sanja Jelic, MD on August 29, 2018 Sanja Jelic, MD is board-certified in pulmonary disease, sleep medicine, critical care medicine, and internal medicine. She is an assistant professor and attending physician at Columbia University College of Physicians and Surgeons in New York, NY. Learn about our Medical Review Board Sanja Jelic, MD Updated on September 11, 2019 Print Table of Contents View All Symptoms Causes Diagnosis Treatment Prevention Atelectasis is a medical term used to describe the complete or partial collapse of a lung. It is sometimes referred to as a "collapsed lung," although the term can also be applied to a condition called pneumothorax. When atelectasis occurs, fresh air is unable to reach the tiny structures of lungs, called the alveoli, where oxygen and carbon dioxide are exchanged. This results in decreased levels of oxygen being delivered to the organs and tissues of the body (hypoxia). Atelectasis may be acute, occurring suddenly over the matter of minutes, or chronic, developing over a period of days to weeks. There are four main causes of atelectasis, which in turn may be caused by a number of different medical conditions, ranging from lung cancer, to an enlarged heart. Illustration by Joshua Seong. © Verywell, 2018. Atelectasis Symptoms Atelectasis often has few symptoms if it develops slowly or involves only a small portion of the lung. Conversely, if the condition develops rapidly or affects a larger portion of shock, symptoms may be dramatic and even lead to shock. Atelectasis typically occurs unilaterally, meaning in either one lung or the other. Common symptoms include: Shortness of breath (dyspnea)WheezingRapid shallow breathingA persistent, hacking coughA sharp chest pain that worsens with a deep breath, typically on one side of the chest As the condition progresses, the symptoms can become more profound as oxygen saturation levels in the blood begin to decrease. This can lead to a sudden, severe drop in blood pressure, rapid heart rate (tachycardia), and shock. When to Seek Emergency Care Call 911 or seek emergency care if the breathing difficulty is accompanied by severe chest pain, rapid heart rate, rapid breathing, clammy skin, lightheadedness, or cyanosis (a bluish color of the skin, particularly the lips, chest, and tongue). Causes There are four primary causes of atelectasis: hypoventilation, airway obstruction, airway compression, and adhesions. Understanding these mechanisms makes it a little easier to understand some of the common medical conditions that may result in this condition. Hypoventilation Hypoventilation, or breathing at an abnormally slow rate, is common during surgery, especially with general anesthesia, or when a person is placed on a respirator. The very act of shallow breathing prevents air from getting to the alveoli, causing the air sacs to deflate and collapse. Hypoventilation is the most common cause of atelectasis, especially after chest surgery. Airway Obstruction Airway obstruction may be caused when something blocks a passage either inside the lung (like a mucus plug or a foreign object) or outside of the lungs (like a tumor which presses on the airway and causes obstruction). Bronchioloalveolar carcinoma is one type of cancer (now renamed as a subtype of lung adenocarcinoma) known to cause tumors in the alveoli and allied passages. Airway Compression Compression of the airways is often caused by the buildup of fluid in the space surrounding the lungs (pleural effusion). It may also be the result of an enlarged heart, an aneurysm, a tumor, enlarged lymph nodes, or accumulation of fluids in the abdominal cavity (ascites). Adhesions Adhesions are an abnormal condition where tissues begin to stick together. Normally, internal tissues and organs have slippery surfaces, so they can shift easily as the body moves. Other Factors Other factors contributing to atelectasis include obesity, smoking, prolonged bed rest/immobility, rib fractures (which can result in shallower breathing), narcotics or sedatives (which can slow respiration), and respiratory distress syndrome (RDS) in newborns. Diagnosis If your doctor suspects you have atelectasis, he or she will perform a physical exam by tapping on (percussing) the chest to listen for tell-tale sounds. If there is a partial or complete lung collapse, breathing sounds may be quiet or noticeably absent. Normal and Abnormal Breath Sounds Following this, the doctor will order a number of investigations which may include: Chest X-ray, which may reveal that the trachea and heart have shifted positionComputed tomography (CT scan) to look for visual evidence of obstructionMagnetic resonance imaging (MRI), using magnetic waves to produce imagesBronchoscopy, a flexible scope inserted into the windpipe to view the lungs that may reveal a tumor or foreign body in an airway that has led to the collapseBlood gases (oximetry) to evaluate the level of oxygen deprivationPositron-emission tomography (PET scan), which can spot hyperactive cell metabolism as can occur with cancer Treatment Treatment of atelectasis depends on the underlying cause, with the aim of re-expanding the lung to its normal size. The approaches can vary. If a tumor is the cause of the collapse, surgery may be involved. With small degrees of atelectasis that are found while an infection or tumor is being actively treated, physicians may simply observe the area of atelectasis to see if it resolves with appropriate treatment of the underlying problem. In this case, breathing exercises, chest percussion, or postural drainage may help accelerate improvement and relieve some of the symptoms. For pleural effusion, drainage of the pleural cavity may be required. For internal obstructions, bronchoscopy may be used to remove a foreign object, while bronchodilation medications may assist with the opening of airway passages. In most cases, a combination of therapeutic approaches will be needed. When symptoms are pronounced, positive end-expiratory pressure (PEEP) may be used. This is a treatment in which a mixture of oxygen is given via endotracheal tube, preventing the lungs from collapsing completely during exhalation. If symptoms are severe, intubation and ventilation (placing a person on a respirator) may be needed until the underlying condition is fully under control. When atelectasis is chronic, it can often be difficult to get the lungs to re-expand. Removal of the damaged portion of the lung (via a lobectomy or segmental resection) may be indicated. Complications Complications may result when bacteria become trapped in the area of the collapse. This can lead to the development of an infection, including pneumonia and sepsis. Bronchiectasis, an abnormal widening of the airways which results in a pooling of fluid the lungs, can also sometimes occur. When a large portion of the lungs is affected by these things, respiratory failure may result. Prevention Chest surgery remains the predominant cause of atelectasis. To prevent it from occurring after a surgical procedure, doctors will typically advise you to stop smoking first and foremost. After surgery, there are four things you should do ensure your lungs remain fully inflated: Use an incentive spirometer, a simple medical device to keep your lungs healthy. It's the most used device that prevents atelectasis.Perform deep breathing exercises, focusing on long inhales and controlled exhales. Pain medication may also be prescribed if breathing is especially uncomfortable.Make an effort to cough to clear any mucus or sputum from the lungs.Change your position, sitting up or moving around as much as your doctor allows. How to Prevent and Treat Atelectasis After Surgery Was this page helpful? Thanks for your feedback! Limiting processed foods and red meats can help ward off cancer risk. These recipes focus on antioxidant-rich foods to better protect you and your loved ones. Sign up and get your guide! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Heart, Lung, and Blood Institute. Atelectasis. Cleveland Clinic. Atelectasis. Updated January 15, 2018. Ferrando C, Romero C, Tusman G, et al. The accuracy of postoperative, non-invasive Air-Test to diagnose atelectasis in healthy patients after surgery: a prospective, diagnostic pilot study. BMJ Open. 2017;7(5):e015560. doi:10.1136/bmjopen-2016-015560 American Cancer Society. What Is Lung Cancer? Updated October 1, 2019. Cleveland Clinic. Pleural Effusion Causes, Signs & Treatment. Updated December 18, 2018. Woodring JH, Reed JC. Types and mechanisms of pulmonary atelectasis. J Thorac Imaging. 1996;11(2):92-108. doi:10.1097/00005382-199621000-00002 Cleveland Clinic. Atelectasis: Prevention. Updated January 15, 2018. Cleveland Clinic. Atelectasis: Management and Treatment. Updated February 13, 2018. Östberg E, Thorisson A, Enlund M, Zetterström H, Hedenstierna G, Edmark L. Positive End-expiratory Pressure and Postoperative Atelectasis: A Randomized Controlled Trial. Anesthesiology. 2019;131(4):809-817. doi:10.1097/ALN.0000000000002764