A 50-year-old know asthmatic develops sudden onset right-sided chest pain with dyspnea. Chest X-ray reveals hyperlucency on right side with shift of trachea to left side. The best option of treatment for immediate relief of symptoms is
**Core Concept**
The patient's presentation suggests a spontaneous pneumothorax, which is a life-threatening medical emergency that requires immediate attention. A pneumothorax occurs when air enters the pleural space, causing the lung to collapse and leading to respiratory distress.
**Why the Correct Answer is Right**
In cases of spontaneous pneumothorax, particularly in patients with pre-existing lung conditions like asthma, the sudden onset of chest pain and dyspnea is a red flag for a pneumothorax. The chest X-ray findings of hyperlucency on the right side and tracheal shift to the left confirm the diagnosis. The immediate relief of symptoms requires the insertion of a chest tube to allow air to escape from the pleural space, thereby re-expanding the lung.
**Why Each Wrong Option is Incorrect**
* **Option A:** Oxygen therapy alone would not be sufficient to treat a spontaneous pneumothorax, as it would not address the underlying cause of the lung collapse.
* **Option B:** Bronchodilators may be useful in managing asthma symptoms, but they would not address the immediate need to re-expand the lung in a spontaneous pneumothorax.
* **Option C:** Non-invasive ventilation may be used in some cases of respiratory distress, but it is not the best option for immediate relief in a spontaneous pneumothorax.
**Clinical Pearl / High-Yield Fact**
In cases of spontaneous pneumothorax, the clinical presentation of sudden onset chest pain and dyspnea is often accompanied by a characteristic "retraction" sign, where the patient's chest wall appears to be pulled inwards due to the negative intrathoracic pressure.
**Correct Answer:** C. Chest tube insertion