True or false: A simple pneumothorax can progress to a tension pneumothorax?

• A. True
• B. False
• C. Not sure
• D. Not applicable

Answer: (A)

A simple pneumothorax can progress to a tension pneumothorax because air continues to enter the pleural space while its exit is blocked. When air keeps accumulating and intrapleural pressure rises, the lung on the affected side can collapse further, and the growing pressure pushes the mediastinum and great vessels toward the opposite side. This impairs venous return to the heart, reduces cardiac output, and creates the life-threatening picture of a tension pneumothorax. In other words, a stable pneumothorax can become dangerous if the leak behaves like a one-way valve or if conditions (like positive-pressure ventilation or ongoing injury) prevent air from escaping.