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Pleurisy

Pleurisy

Pleurisy describes the chest pain syndrome characterized by a sharp chest pain that worsens with breathing.

 

Pleurisy is caused by inflammation of the linings around the lungs (the pleura), a condition also known as pleuritis.

 

There are two layers of pleura: one covering the lung (termed the visceral pleura) and the other covering the inner wall of the chest (the parietal pleura). These two layers are lubricated by pleural fluid.

 

Pleurisy is frequently associated with the accumulation of extra fluid in the space between the two layers of pleura. This fluid is referred to as a pleural effusion.

 

The pain fibers of the lung are located in the pleura. When this tissue becomes inflamed, it results in a sharp pain in the chest that is worse with breathing. Other symptoms of pleurisy can include cough, chest tenderness and shortness of breath.

Symptoms

You can have many symptoms with pleurisy.

  • Chest pain: This is the most commonsymptom. The pain is generally a sharp, stabbing pain, but may also be a dull acheor a burning sensation. It is usually worse when you take a deep breath, cough, or move around. The pain is usually better if you take shallow breaths or lie on the side that hurts. Chest pain is what usually causes people with pleurisy to seek medical attention.
  • Cough: You may get a cough, depending on the cause of the pleurisy. Your cough may be dry or productive of sputum or blood.
  • Shortness of breath: The shortness of breath associated with pleurisy may be due to the underlying cause, such as a blood clot in the lungs or pneumonia, or it may be due to the chest pain caused by breathing.
  • Fever: You may also get a fever, depending on the cause of the pleurisy.

Causes

There are many causes of pleurisy:

  • Infectious disease caused by virus, bacteria, fungus, tuberculosis, or parasites.
  • Cancer such as mesothelioma or spread from other areas.
  • Collagen vascular disease such as lupus, rheumatoid arthritis, sarcoid disease, orscleroderma.
  • Trauma from bruised or broken ribs.
  • Gastrointestinal disease, for examplepancreatitis, peritonitis, or a collection ofpus under the diaphragm.
  • Reaction to drugs such as methotrexate (Rheumatrex, Trexall) and penicillin.
  • Other causes:

       - Uremia.

       - Blood clot in lung.

       - Radiation therapy.

       - Sickle cell disease.

       - Chemotherapy drugs.

       - Asbestos.

       - HIV.

Treatment

Some chest pain is dangerous. Sometimes even an experienced doctor can't tell you the exact cause of your pain. Pleurisy is frequently diagnosed only when other more serious causes have been ruled out.

  • Use an anti-inflammatory medicine, such as ibuprofen (Motrin) or aspirin, to reduce the pain and inflammation.
  • You may have less pain if you lie on the side that hurts.
  • Avoid exerting yourself or doing anything that would cause you to breathe hard.
  • Call your doctor or go to your hospital's emergency department if you can't breathe deeply or cough because of severe pain.

 

When you have been diagnosed with pleurisy and more serious causes of chest pain have been ruled out, you will probably get aprescription for pain medicine.

  • You may be prescribed an anti-inflammatory drug such as ibuprofen (Motrin), indomethacin (Indocin), ornaproxen (Naprosyn). You may even receive stronger medicine, such ascodeine, hydrocodone (Vicodin), oroxycodone (Percocet).
  • If you have a lot of fluid in your chest, it may need to be drained.
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