Patients often have triggering factors such as holding heavy objects, breath-holding, and strenuous exercise. Patients suddenly feel chest pain, shortness of breath, and breath-holding, and may have cough. A small amount of pneumothorax starts with shortness of breath, but gradually settles down after a few hours, and may not be detected by X-ray chest film. If the pneumothorax volume is larger or if there is an existing extensive lung disease, the patient often cannot lie down. The degree of dyspnea is related to the amount of air accumulation and the extent of the original intrapulmonary lesion. When there are pleural adhesions and reduced lung function, even a small amount of limited pneumothorax may have significant chest pain and shortness of breath. Symptoms include: 1. Chest pain: Most patients have varying degrees of chest pain. This is caused by the pulling and tearing of pleural adhesions. Chest pain may occur suddenly with stabbing or distending pain, and the pain increases when coughing and deep inspiration. The elderly are sluggish and the chest pain is often less obvious than that of young people, therefore, it is easy to cause a delay in early diagnosis; 2. dyspnea: it often occurs simultaneously with chest pain, and in young people the pulmonary compression is less than 20% and dyspnea is not obvious. Older people mostly have chronic lung diseases and poor lung function, when the lung compression is only 10%, there can be obvious dyspnea. If it is a high-pressure pneumothorax, the patient may have progressive dyspnea, even shock, respiratory failure, etc.; 3, cough: mostly dry cough, caused by reflex stimulation of the pleura. If combined with infection or bronchopleural fistula, the cough will be aggravated and purulent sputum will be coughed up; 4.shock: if the high-pressure pneumothorax is not treated in time, the patient may suffer from shock. At this time, in addition to dyspnea, the patient has cyanosis, profuse sweating, irritability, unconsciousness, cold extremities, weakened pulse, decreased blood pressure, and even death. The signs of spontaneous pneumothorax in the elderly are easily masked by the primary disease (e.g. chronic bronchitis combined with obstructive emphysema), resulting in delayed diagnosis. At this time, X-ray examination can help to confirm the diagnosis and to understand the degree of lung compression. Also, noting the tracheal deviation is often a helpful hint.