Does the chest bilaterally expand if you have a spontaneous pneumothorax ? are there always symptoms associated with it?

Depends: Hopefully, a pneumothorax does not involve both sides! a large bilateral pneumothorax tends to be fatal! the lung will re-expand if a chest tube is placed or if the leak of air around the lung seals itself and the pneumothorax is slowly absorbed. Symptoms depends on the size of the pneumothorax and range from minimal to severe shortness of breath.

Not necessarily: Early on there may not be many symptoms. A potentially fatal tension pneumothorax will definitely be symptomatic. Spontaneous pneumothorax usually results from spontaneous rupture of congenital blebs or bullae usually in the apexes. When a cluster of blebs is identified on a cat scan of the lungs, definitive removal of the blebs with abrassive and possibly talc pleurodesis is curative.