Pleurisy: Sharp Chest Pain With Deep Breaths, Causes and When to Be Seen

What it involves

MedlinePlus explains that pleurisy is an inflammation of the lining of the lungs and chest, called the pleura, that leads to chest pain when you take a deep breath, sneeze or cough. Normally smooth, the two layers become rough and rub together with each breath. Pleurisy is a sign of something else going on, not a disease on its own, so finding the cause is the point of the visit.

Who this is for

• Adults with sharp chest pain that gets worse with deep breaths, coughing or sneezing.
• Patients who recently had a cold, flu, bronchitis or pneumonia and now have chest pain.
• People with lupus or rheumatoid arthritis who notice new pain with breathing.
• Anyone with a recent rib injury or chest bruise who has pain when breathing in.

What to expect

• Questions about when the pain started, what makes it better or worse, and recent illness or injury
• A lung exam, where a provider may hear a rough, grating friction rub with the stethoscope
• An EKG at the Loxahatchee or West Palm Beach office, blood work, and a referral for a chest x-ray, ultrasound or CT
• A plan for the cause, with pain control and clear instructions on warning signs

What pleurisy pain is like

MedlinePlus says the main symptom is chest pain that often occurs when you breathe in or out, or cough, and that it often feels sharp. Some people feel it in the shoulder. Deep breathing, coughing, sneezing and chest movement make it worse. If fluid collects around the lung, cough, shortness of breath, rapid breathing and pain with deep breaths can follow. The chest pain guide explains which kinds of chest pain are an emergency.

Common causes

MedlinePlus says pleurisy can develop when a lung infection, such as a viral infection, pneumonia or tuberculosis, inflames the lining. A viral infection is the most common cause. It can also occur with certain cancers, chest trauma, a blood clot in the lung, rib fractures, sickle cell disease, rheumatoid arthritis and lupus. The pneumonia guide, rheumatoid arthritis guide and lupus guide describe three of those causes in more detail.

Conditions that must not be missed

Several serious problems cause pain with breathing, including a blood clot in the lung, a collapsed lung and a heart problem. That is why a provider takes this symptom seriously instead of assuming a pulled muscle. The leg blood clot warning signs guide explains the clot symptoms that raise concern, and the shortness of breath guide explains when trouble breathing becomes urgent. A rib or chest wall problem is also possible, so the exam looks at where the pain can be pressed. Sharp chest pain that eases when you sit up and lean forward can also come from inflammation of the sac around the heart, which the pericarditis chest pain guide explains, and any new chest pain deserves a 911 call first.

How a provider looks for it

According to MedlinePlus, a stethoscope may pick up a friction rub, and a provider may order a complete blood count, a chest x-ray, a CT scan or an ultrasound of the chest, or remove fluid with a needle for analysis. Serenity By A Dr. Sareen offers EKGs at its Loxahatchee and West Palm Beach offices and lists blood work among its services, while imaging and fluid removal are arranged by referral. The heart palpitations guide describes how heart rhythm is checked.

Treatment depends on the cause

MedlinePlus says bacterial infections are treated with antibiotics, surgery or a chest tube may be needed to drain infected fluid, and viral infections normally run their course without medicine. Acetaminophen or ibuprofen can help reduce pain. Because ibuprofen can irritate the stomach and affect blood pressure and kidneys in some people, ask your provider which pain reliever suits you. Recovery depends on the cause and on your general health.

Smoking, prevention and follow-up

MedlinePlus says early treatment of bacterial respiratory infections can prevent pleurisy. A cough that lingers after an illness should be checked rather than endured, and smokers who also have chest pain deserve an honest conversation about quitting, which the quitting smoking guide describes. Follow-up matters when fluid was present, because it can return. Bring a list of recent symptoms and medicines to the visit, and tell staff if the pain is getting worse. When a larger collection of fluid builds up between the lung and the chest wall, breathlessness often joins the chest pain, and the pleural effusion guide explains its causes, how it is found and how it is drained.

Sources

• MedlinePlus: Pleurisy (medical encyclopedia)
• MedlinePlus: Pleural Disorders (health topic)