Which of the following best represents a sign that may indicate tension pneumothorax?

• A. JVD with tracheal deviation
• B. Headache only
• C. Nausea only
• D. Muscle cramps

Answer: (A)

Tension pneumothorax causes air to build under pressure in the chest, pushing the mediastinum and compressing the heart and great vessels. This pressure disrupts return of blood to the heart, so the veins in the neck become distended (jugular venous distention). As the mediastinum shifts away from the affected side, the trachea also moves from its midline position. The combination of jugular venous distention and tracheal deviation is a classic, urgent sign of this condition and signals the need for immediate action.

Headache, nausea, or muscle cramps can occur for many reasons and don’t reflect the acute chest compressive physiology seen in tension pneumothorax. They don’t indicate mediastinal shift or compromised venous return, so they aren’t the signs that point to this emergency.