Pneumothorax (Tension) By Thomas G Weiser, MD, MPH, Stanford University School of Medicine Reviewed / Revised Apr 2022 | Modified Sep 2022 View Patient Education Symptoms and Signs Diagnosis Treatment Topic Resources Tension Pneumothorax How to do Needle Thoracostomy How to Do Tube Thoracostomy Tension pneumothorax is accumulation of air in the pleural space under pressure, compressing the lungs and decreasing venous return to the heart.