Chest Injuries and Disorders

Chest injuries are injuries to your chest area — anywhere between your neck and abdomen (tummy).

Damage may be to:

• your chest wall — which includes your bones, muscles, fat and skin
• the organs or blood vessels inside your chest (including your heart and lungs)

Chest injuries can cause:

• Bruising, cuts or scrapes to the chest wall.
• Broken bones — for example, fractured ribs, collar bone or sternum (breastbone).
• Dislocated joints.
• Damage to your heart or blood vessels, including your aorta — the main artery that delivers blood to the rest of your body.
• Damage to your lungs — for example, bruising (pulmonary contusions) or a laceration (cut).
• A collapsed lung.
• Rarely, injuries to your oesophagus (food pipe), trachea (windpipe) or diaphragm.

Broken ribs

One of the most common chest injuries is fractured ribs (broken ribs). This is when your ribs crack or break. Problems associated with fractured ribs can include:

• pneumothorax — when air leaks into the space between one of your lungs and your chest wall, which can cause a collapsed lung
• haemothorax — when blood collects in the space between one of your lungs and your chest wall
• flail chest — when several ribs next to each are broken in more than one place

Symptoms of chest injuries vary, depending on the type of injury.

Signs and symptoms of dangerous chest injuries can include:

• bleeding from the injury
• pain in your chest
• difficulty breathing
• fast or shallow breathing
• reduced or different movement of your chest with breathing
• a ‘crunchy’ or ‘crackling’ feeling under the skin of your chest

With a serious injury, you may:

• look pale
• lose consciousness or collapse
• have a fast heart rate and low blood pressure

Other signs of a chest injury can include:

• tenderness when touching your chest or back over the ribs
• bruising of your skin

Chest injuries may be caused by:

• Blunt chest trauma — such as from sport, a punch or kick, a fall or car accident.
• Penetrating trauma — such as from a gunshot or a knife wound, where an object punctures the chest wall.

Penetrating injuries may have separate entry and exit wounds.

Chest injuries can be minor, such as bruising. But even minor chest injuries should be checked by your doctor, who can tell you what to do if your symptoms get worse.

Serious chest injuries need urgent medical attention.

Chest injuries that interfere with your breathing or circulation (blood flow) can be serious or life threatening.

If the injury is severe, there may be internal bleeding. You may also have other injuries, most often head and abdominal (tummy) injuries.

Your doctor will ask about your symptoms and do a physical examination.

They may recommend tests, such as:

• a chest x-ray
• an ultrasound scan
• a CT scan

These tests are often done in hospital if you have had a chest injury. You may also have other tests, such as blood tests or an electrocardiogram (ECG).

Treatment of a chest injury will depend on:

• the cause of your injury
• the type of injury you have

If you have a severe chest injury, you will need treatment in hospital. You may need to have:

• oxygen
• pain-relief medicines
• fluids given through a drip
• monitoring of your breathing and heart
• help with breathing
• a procedure or surgery to treat your injury
• chest physiotherapy

Fractured ribs

A fractured rib will heal on its own, but it takes time — up to 8 weeks.

If you have fractured ribs, you may be asked to breathe deeply and cough regularly. This helps to prevent pneumonia, a type of chest infection.

If you are in pain, take pain-relief medicines. Pain relief is important as it will help you feel more comfortable to cough, take deep breaths and do any breathing exercises you are given.

If your injury is minor, try to keep moving around and doing what you normally do. But avoid lifting, bending and any strenuous exercise until your pain and other symptoms have gone.

One of the most common complications of rib fracture or chest injury is a chest infection such as pneumonia.

Other complications can include:

• blood clots
• breathing problems
• damage to organs such as your spleen, liver or kidneys from broken ribs