Amphoric Breath Sound in Pneumothorax

 

1. Mechanism in an open pneumothorax

Amphoric breathing can occur when there is:

A large air-filled pleural space.

Communication between the pleural cavity and atmosphere through an open chest wound.

Air movement producing a resonant, hollow sound similar to blowing over a bottle.

This is classically described as amphoric breathing in an open pneumothorax.

2. In tension pneumothorax:

Air enters the pleural cavity through a valve-like mechanism.

Air becomes trapped.

Intrapleural pressure increases.

The lung collapses.

Mediastinal shift and reduced venous return may occur.

Typical auscultatory finding:

Markedly diminished or absent breath sounds on the affected side.

3.  In a closed tension pneumothorax, there is no open communication allowing the characteristic bottle-like resonance.

If amphoric breathing is described in a patient with tension pneumothorax, consider:

An open pneumothorax.

Bronchopleural fistula.

A pre-existing pulmonary cavity.

An atypical or incorrectly described examination finding.