Hemothorax on a chest X-ray

Hemothorax means blood has collected in the pleural space, the narrow area between the lung and chest wall. Trauma is a common cause, but bleeding can also follow a procedure, surgery, a lung or blood-vessel problem, or another chest condition. On an X-ray, the collection may appear as a white or hazy area at the lower chest, although the image cannot always determine whether fluid is blood.

A clinician will consider your breathing, pulse, blood pressure, oxygen level, injury history, medicines, and examination findings. Further imaging or blood tests may be needed. Treatment depends on the amount of blood and its effect on breathing and circulation; it may involve observation, drainage through a chest tube, or treatment of an ongoing source of bleeding. Do not drive yourself if you are breathless or faint.

Call emergency services for sudden breathlessness, chest pain after an injury, blue lips, fainting, confusion, coughing blood, severe weakness, or rapidly worsening symptoms. A suspected hemothorax can reduce lung expansion and blood circulation, so urgent hospital assessment is appropriate even when the initial X-ray report is not yet available.

Ask what the X-ray showed, whether the fluid could be blood or another substance, what further tests are needed, and how your breathing and blood count will be monitored. Ask which symptoms should prompt immediate return to hospital.