What are the symptoms of a tension pneumothorax?

The symptoms associated with a tension pneumothorax are well characterized by severe respiratory distress, hypotension, and unilateral decreased breath sounds. In a tension pneumothorax, air enters the pleural space and is trapped, leading to increased pressure that collapses the lung on the affected side and pushes the mediastinum towards the opposite side. This results in significant respiratory distress, as the lung cannot expand properly, causing difficulty in breathing and reduced ventilation efficiency.

Hypotension occurs because the increased pressure in the pleural space can restrict venous return to the heart, leading to reduced cardiac output. The shift in mediastinal structures can also compromise cardiovascular function, exacerbating hypotension. Unilateral decreased breath sounds indicate that the lung on the affected side is not functioning due to compression, a hallmark sign of tension pneumothorax.

In contrast, the other options do not align with the typical clinical presentation of a tension pneumothorax. Mild respiratory distress and headache, fever and cough, or abdominal pain and nausea are not characteristic symptoms of this acute and life-threatening condition. Therefore, recognizing the combination of severe respiratory distress, hypotension, and unilateral decreased breath sounds is crucial for timely diagnosis and management of tension pneumothorax.