In pneumothorax, which of the following best describes a physical examination finding?

• A. Normal breath sounds
• B. Tracheal shift
• C. Heart sounds may be displaced
• D. Murmurs

Answer: (C)

When a pneumothorax is large or tensioning, air build-up increases intrathoracic pressure and shifts the mediastinal structures away from the affected side. That shift can cause the heart to move in the chest, so auscultated heart sounds may appear displaced from their normal location. This sign reflects significant mediastinal shift and potential hemodynamic compromise. In contrast, you’d more commonly expect decreased or absent breath sounds on the affected side and hyperresonance; murmurs aren’t characteristic of pneumothorax. While tracheal deviation can occur in a tension pneumothorax, displacement of the heart sounds directly highlights mediastinal shift and is the best described exam finding here.