Overview
Pleurisy, also known as pleuritis, is a medical condition in which the pleura, the two large, thin layers of tissue that separate the lungs from the chest wall, become inflamed. This results in sharp chest pain that worsens during breathing, a condition known as pleuritic pain. The pleural layers act like smooth satin, allowing the lungs to expand and contract during breathing. Inflammation causes the layers to rub against each other like sandpaper, leading to pain when breathing in and out. Pleurisy can also cause pleural effusion, atelectasis, or empyema. Treatment involves pain management and addressing the underlying cause.
Understanding the disease
Symptoms
Symptoms of pleurisy may include:
- Chest pain that worsens with breathing, coughing, or sneezing
- Shortness of breath due to attempting to limit breathing
- Cough (in some cases)
- Fever (in some cases) Pleurisy can also be accompanied by pleural effusion, atelectasis, or empyema. Pleural effusion occurs when fluid builds up between the two layers of pleura, which can reduce or eliminate pleuritic pain. Atelectasis is a condition where the lung partially or completely collapses due to pressure from fluid in the pleural space. Empyema happens when the fluid in the pleural space becomes infected and forms pus. If you experience unexplained, intense chest pain while breathing, it is essential to seek medical attention from a healthcare provider as soon as possible, as it may indicate a problem with your lungs, heart, pleura, or an underlying medical condition that requires prompt care.
Development
Pleurisy develops when the pleura, the two large, thin layers of tissue that separate the lungs from the chest wall, becomes inflamed. This inflammation can cause the pleural layers to rub against each other, resulting in pain that worsens during breathing. Pleurisy can be caused by a variety of conditions, including viral infections, bacterial infections, fungal infections, autoimmune disorders, lung cancer, pulmonary embolism, and tuberculosis. In some cases, pleurisy can occur with pleural effusion, atelectasis, or empyema. Symptoms of pleurisy may include chest pain that worsens with breathing, shortness of breath, cough, and fever. It is important to see a healthcare provider if you experience unexplained, intense chest pain during breathing.
Assessment and Diagnosis
Triage
You should see a doctor if pleurisy is suspected when you experience unexplained, intense chest pain during breathing. This may indicate a problem with your lungs, heart, or pleura, or an underlying illness that requires prompt medical care. In such cases, you should call your healthcare provider or seek emergency care right away.
Diagnosis
To diagnose pleurisy, your health care provider will likely start by asking about your medical history and performing a physical exam that includes listening to your chest with a stethoscope. They may also recommend various diagnostic tests such as blood tests, chest X-ray, computerized tomography (CT) scan, or ultrasound. In some cases, diagnostic procedures like thoracentesis or thoracoscopy may be performed to remove fluid and tissue from the pleural space for testing. These tests and procedures can help determine if you have pleurisy and identify its cause.
Management and Treatment
Complications
Complications of pleurisy can arise due to the underlying cause or the inflammation itself. Some potential complications include:
- Pleural Effusion: Fluid buildup between the layers of pleura can occur, lessening the friction and reducing the sharp pain associated with pleurisy. However, this excess fluid can lead to further complications, such as reduced lung function and difficulty breathing.
- Atelectasis: Increased fluid in the pleural space can compress the affected lung, causing it to partially or completely collapse. This makes breathing difficult and may lead to respiratory failure.
- Empyema: Infection within the pleural space can result in the accumulation of pus, known as an empyema. This can cause further complications like fever, chest pain, and difficulty breathing.
- Pneumothorax: The inflammation and increased pressure in the pleural space can cause the lung to rupture and air to leak into the space surrounding the lungs. This can lead to difficulty breathing and may require medical intervention.
- Chronic Pleurisy: If the underlying cause is not addressed, the inflammation in the pleura can persist and lead to chronic pleurisy. This can result in ongoing pain, reduced lung function, and a decreased quality of life. It is essential to seek medical attention if you experience unexplained, intense chest pain during breathing, as prompt treatment can help prevent potential complications.
Treatment
Treatment for pleurisy involves managing pain and addressing the underlying cause. Here are some common approaches:
- Pain management: Over-the-counter pain relievers like acetaminophen or ibuprofen can help alleviate pain. In more severe cases, doctors may prescribe stronger pain medication or muscle relaxants.
- Rest: It's essential to rest when suffering from pleurisy. Avoiding strenuous activities and taking it easy can help manage symptoms.
- Heat or cold therapy: Applying warm or cold compresses to the chest can help alleviate pain and discomfort. Try alternating between hot and cold packs to find what works best for the individual.
- Antibiotics: If pleurisy is caused by a bacterial infection, antibiotics will be prescribed to treat the underlying infection.
- Inhalers: For cases caused by asthma or chronic obstructive pulmonary disease (COPD), inhalers may be prescribed to help manage symptoms.
- Oxygen therapy: In cases where breathing becomes difficult, oxygen therapy may be administered to help increase oxygen levels in the blood.
- Fluid management: If pleurisy is accompanied by pleural effusion, fluid may be drained using a needle or chest tube to help relieve symptoms. It's important to consult a healthcare professional for a proper diagnosis and appropriate treatment plan.