What imaging finding would indicate a pneumothorax from CVAD insertion?

• A. Decreased breath sounds, respiratory distress, chest pain
• B. Normal lung sounds
• C. Increased chest expansion
• D. No symptoms

Answer: (A)

Pneumothorax after CVAD placement is confirmed by imaging that shows air in the pleural space. The hallmark on chest radiograph is a visceral pleural line with no lung markings beyond it, indicating the edge of the collapsed lung separated from the chest wall by free air. In larger or tension cases, you may also see mediastinal shift or a deep sulcus sign. Ultrasound offers another clue by showing loss of normal lung sliding and the potential to identify a “lung point.” Clinically, symptoms like decreased breath sounds, respiratory distress, and chest pain can raise suspicion, but imaging provides the definite confirmation.