Giant Emphysematous Bulla Mimicking Tension Pneumothorax

Abstract

A 37-year-old man presented with chest tightness and mild shortness of breath for several hours. Medical history was minimal except for smoking 20 cigarettes per day for many years. Vital signs included pulse rate 58 beats per minute, respiratory rate 20 breaths per minute, and blood pressure 105/68mm Hg. Physical examination showed decreased breath sounds over the right lung and no jugular vein engorgement. Chest roentgenogram showed decreased lung markings with emphysematous changes in right lung field and mild deviation of the heart to the left (Figure 1).