Pleurisy mainly involves the inflammation of the tissue layers (pleura) lining the lungs and inner chest wall. Pleurisy is mainly associated with the accumulation of fluid between the two layers of pleura, known as pleural effusion. Pleurisy is caused by a variety of conditions, such as:
The signs of pleurisy include chest pain that is aggravated by breathing in, shortness of breath, and local tenderness. The pain affects the chest cavity in both the front and back of the cavity. It also causes pain over the neck and shoulder as well. An analysis of pleurisy is determined by the severity of the chest pain and the physical findings of tests performed on the chest. It is also associated with pleural accumulation of fluid (pleural effusion), which is part of the imaging studies using a chest X-ray, ultrasound, or CT scan. An analysis of pleural fluid aspirated helps make an accurate diagnosis of the chest pain in pleurisy.
What Does Pleurisy Do?
Pleurisy is mainly a disease that causes chest pain and is characterized by sharp chest cavity pain that worsens, making breathing difficult. The disease is caused by inflammation of the linings around the lungs, called pleura. The condition is also known as pleuritis. There are two layers of pleura: one layer covers the lung and is called the visceral pleura; the other layer covers the inner wall of the chest and is called the parietal pleura. Both layers are lubricated by pleural fluid.
Pleurisy is regularly associated with the accretion of extra fluid available between two layers of pleura. This fluid is referred to as pleural effusion.
The pain fibers of the lung are located inside the pleura. When the tissue becomes inflamed, it results in sharp chest pain that worsens with heavy breathing. Other symptoms of pleurisy are a severe cough, tenderness in the chest, and uneven breathing.
Pleurisy can be caused by any of the following conditions:
Bacterial infections that cause tuberculosis, fungi, parasites, and other viruses
Inhaled toxic and chemicals substances, which expose cleaning agents like ammonia
Pulmonary embolism, which can cause blood clots in the blood vessels in the lungs. The clots can severely affect the blood and oxygen that is passed to the lung and can result in the death of part of the lung tissues as well as pleurisy.
Obstruction of lymph channels, which can result in the development of lung tumors
Trauma due to rib fractures or irritation, which occur in the area from chest tubes used to drain air or fluid from the pleural cavity in the chest
A number of drugs that can cause lupus-like syndromes, such as hydralazine (Apresoline), Procan (Pronestyl), Procan SR, and Procanbid, but these branded drugs are presently not available in the United States.
The common symptom of pleurisy is pain, which becomes aggravated during inspiration. The lungs themselves do not have any pain nerves, but the pleura have an abundance of nerve endings. As fluid accumulates, the space between the two layers around the pleura experience mild pain, known as pleurisy. Large amounts of fluid limit the expansion of the lungs, making breathing difficult.
Pleurisy occurs when the linings of the lungs and chest become inflamed. A variety of factors also cause inflammation, including viral infections, autoimmune diseases, certain medications, lung cancer, chest wounds, and inflammation in other parts of the body, such as pancreatitis.
Timely medications and regular medical check-ups will help one overcome pleurisy.
Pleurisy severely affects the lining between the lungs and chest wall. The pleural space is located between the lungs and inner chest wall. Fluid settles in between the two lubricated surfaces. Normally, there should be nothing in the pleural space.
The pleura is composed of two layers made of thin lining tissue. The layer covering the lung is called visceral pleura, while the parietal pleura covers the inner wall of the chest. Both are lubricated with pleural fluid. Generally, there is about 10–20 ml of clear liquid that acts as a lubricant between these layers. The fluid is repeatedly absorbed and can be replaced using the outer lining of the pleura. Pressure building inside the pleura is bad and can worsen during inspiration (the process of breathing in), but can lessen during exhalation (the process of breathing out). The space between the two layers around pleura always has negative pressure. The introduction of air, which is a positive pressure, enters the space, resulting in the closing of the lung.
4 Making a Diagnosis
Making a diagnosis of pleurisy is done by performing several tests and procedures.
Consult your doctor if you are having a severe chest pain that worsens when you breathe.
Write down all the symptoms as well as the vitamins, supplements and medications that you are taking. Ask a family member or a close friend to accompany you.
Some of the questions that you can ask your doctor include:
what do you think is the underlying condition of these symptoms?
Do I need to undergo diagnostic tests?
What treatments do you recommend?
Are there self-care steps I can do?
Do you recommend that I just stay at home?
Should I stop smoking?
Am I at risk of a long term complication?
Your doctor will also ask you questions such as:
How would you describe your symptoms?
Have you been diagnosed with other conditions?
Have you recently traveled?
Do you smoke?
Have you been involved in any work or projects that might have exposed you to asbestos?
While waiting for the appointment, take an over the counter pain reliever and apply a cold compress to your chest.
Your doctor will conduct a physical exam and will check your chest using stethoscope. You may undergo:
blood tests – to check if you have an infection and to rule out other conditions;
chest X-ray – to check if there is fluid or air between the ribs and lungs;
CT scan – to check if there are blood clots in the lung and to find the causes of the pain;
ultrasound – to check if you have pleural effusion;
electrocardiogram or ECG – a heart monitoring tests to rule out heart problems that might cause your chest pains.
Some of the procedures include:
Thoracentesis – your doctor will inject anesthesia where the fluid was seen in your ribs then he will insert a needle through your chest wall to remove the fluid and then he will send it to the laboratory for testing;
Pleural biopsy – this is done by removing a small tissue of the outer pleura to be examined if your doctor suspects that you have tuberculosis or cancer;
Thoracoscopy – your surgeon will check inside your chest and get a sample of pleural tissue.
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