Have you ever felt this way? When you take a deep breath, laugh out loud, or cough, you suddenly feel a sharp, stabbing pain in your chest. This is not normal, and you feel scared. That kind of pain is the main symptom of the condition we are going to talk about, called Pleurisy.
What is Pleurisy?
Simply put, Pleurisy is an inflammation of the thin membrane that surrounds our lungs and another membrane that lines the inside of our chest cavity. These two membranes are called the pleura.
Imagine, there is a small space between these two coverings, the pleural space. It usually contains a small amount of fluid. Like oil in a car engine, this fluid allows the two coverings to slide smoothly together without any friction as the lungs move around when we breathe.
But, what happens if one or both of these coverings become inflamed for some reason? Instead of sliding smoothly, these two coverings start rubbing together. That's when that unbearable, sharp, stabbing pain comes.
What are the symptoms of pleurisy?
Pleurisy can have several symptoms. But the main and most obvious symptom is chest pain. Let's see what these symptoms are.
| Symptom | Description |
|---|---|
| Main symptom: Chest pain |
|
| Other features |
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Important: Chest pain can be caused by other serious conditions (e.g. heart disease) besides pleurisy. Therefore, if you experience unexplained chest pain, never ignore it.
What causes pleurisy?
Pleurisy can occur for a variety of reasons, not just one. Most often, it occurs in a healthy person due to an infection in the lungs.
- Infection: The most common cause is a viral (e.g., influenza virus) or bacterial infection. This swelling occurs when the infection spreads from the lungs to the lining of the pleura.
- Autoimmune diseases: This swelling can also be caused by diseases that attack the body's own cells, such as lupus or rheumatoid arthritis.
- Other lung-related diseases: Conditions such as lung cancer, tuberculosis, and pulmonary embolism.
- Chest injuries: Pleurisy can occur after chest surgery or due to an accident.
- Some medications: Some medications like Hydralazine and Isoniazid may also cause this.
Is pleurisy contagious?
No. Pleurisy is not contagious. However, some viral or bacterial infections (e.g. influenza, pneumonia) that cause pleurisy can be contagious.
Doctor, how do you diagnose this as pleurisy?
When you go to see a doctor with chest pain, he or she will first ask you about the pain. Where does it hurt, what kind of pain it is, and what makes it worse. Then, they will listen to your lungs with a stethoscope. Sometimes a person with pleurisy will hear a harsh, crackling sound coming from their lungs.
In addition, the following tests may be performed to accurately confirm the disease and find its cause.
| Test | What do you see in that? |
|---|---|
| Blood tests | Check for an infection or autoimmune disorder in the body. |
| ECG (EKG) test | Make sure that the cause of chest pain is not heart disease. |
| Imaging tests (X-ray, CT, Ultrasound) | Take pictures of the lungs to find out what the problem is. You can check for things like fluid around the lungs (pleural effusion) or an infection (pneumonia). |
| Fluid testing (Thoracentesis) | Using a very small needle, a small amount of fluid (water) is taken from around the lungs to check for infection or other causes. |
| Thoracoscopy | A small camera is inserted into the chest and directly looked at what the problem is. |
What are the treatments for pleurisy?
The most important thing when treating pleurisy is to find the cause and treat it. In the meantime, your doctor will also give you medication to control the pain you are feeling.
- Treating the cause: If the cause is a bacterial infection, antibiotics will be given. If the cause is a fungal infection, antifungal medications will be given.
- Pain management: Medications such as NSAIDs (Nonsteroidal anti-inflammatory drugs) or corticosteroids may be given to reduce pain and swelling.
- Fluid removal: If there is a lot of fluid around the lungs (pleural effusion), the fluid can be removed (thoracentesis) to reduce pain and make breathing easier.
Does pleurisy go away on its own?
Yes, sometimes. If the cause of pleurisy is a viral infection, the pleurisy may go away on its own as your body fights off the virus. However, if there is a serious underlying cause, such as cancer or an autoimmune disease, the pleurisy will not go away until it is properly treated.
What can I do to reduce the risk?
Although pleurisy cannot be prevented 100%, there are several things you can do to reduce your risk.
- Avoid smoking completely.
- If you have another medical condition, such as an autoimmune disease, get the proper treatment for it.
- Wash your hands regularly with soap and water to protect yourself from viral and bacterial infections.
The most important thing is this. If you experience chest pain, don't ignore it. Chest pain is also a symptom of serious conditions like some heart diseases. Therefore, if you experience chest pain for no apparent reason, go to the nearest hospital's Emergency Department (ETU) immediately.
Take-Home Message
- Pleurisy is a condition caused by swelling of the membrane surrounding the lungs.
- The main symptom is a sharp, stabbing chest pain that increases when you take a deep breath or cough.
- Infections, immune system diseases, and other lung-related diseases can cause this.
- Treatment depends on the cause of pleurisy. Pain control is also an important part of treatment.
- Never ignore chest pain. If you have unexplained chest pain, it is important to seek immediate medical attention at a hospital's Emergency Department (ETU).
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