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Pleurisy and pleuritic pain: Treatment, symptoms, advice & help

About pleurisy and pleuritic pain

Pleuritic pain refers to chest pain which results from the inflammation of the pleura (pleurisy). Pleura is a two-layered covering sac which envelopes the lung and separates it from the chest wall. The two layers of the pleura namely the visceral and parietal pleura are separated by a thin layer of fluid between them. Inflammation of the pleura, termed as ‘pleurisy’ causes intense chest pain (pleuritic pain) along with impairment in expansion and contraction of lungs during breathing.

Pleurisy and pleuritic pain: Incidence, age and sex

Pleurisy can affect an individual of any age, irrespective of gender. The incidence of pleurisy depends upon the underlying causes, which can be several and diverse.

Signs and symptoms of pleurisy and pleuritic pain: Diagnosis

The inflammation of pleural membranes may result in chest pain which is sharp and intense. The pain exacerbates on breathing deeply or coughing. Inflammation of the pleural membrane may also lead to excess fluid collection between the two pleural membranes, thereby hampering its elasticity. This, in turn hampers the lung expansion during breathing, resulting in difficulty in breathing. The affected individuals may experience breathlessness or coughing. In severe cases, decreased oxygen supply to the body tissues may lead to bluish discolouration of skin (cyanosis).

A detailed history and a comprehensive chest examination may help in detecting the condition. Chest auscultation of the individual may reveal a grating sound; also known as ‘pleural rub’ which may occur due to roughened edges of inflamed pleural membranes. Laboratory tests like blood count and imaging diagnostics like chest x-ray or ultrasound of the chest may be required to establish the diagnosis.

Causes and prevention of pleurisy and pleuritic pain

Several factors are known to cause pleurisy, of which lung-related causes seem to be most common culprits. Such lung-related causes include chest infections, inhalation of toxic chemicals, lung cancer or cancer of pleural membranes. Circulatory causes like heart failure, blood clot in vessels supplying the lungs or obstruction of lymphatic fluid may also result in pleurisy. Traumatic causes like rib-fractures may also lead to this condition. Occasionally, medications like phenytoin or hydralazine have also known to cause pleurisy. It is essential to timely manage the aforesaid causes timely, or else they may lead to pleurisy.

Pleurisy and pleuritic pain: Complications

Pleurisy is a serious condition which if ignored, may lead to breathing difficulties. Moreover other complications arising from the underlying cause may also occur concurrently.

Pleurisy and pleuritic pain: Treatment

The first and foremost step in the management of pleurisy is to detect and manage the underlying cause. The breathing problem can be treated by removing fluid from the pleural space and this procedure is termed as ‘thoracocentesis’. Bacterial chest infections require a vigorous course of antibiotics for management. Sometimes, pain-killers and anti-inflammatory drugs may be prescribed to provide symptomatic relief.