Pleurisy
I was quite unwell for a few days with a chest cold, but just as I thought I should be getting better I developed severe chest pain. My first thought was that I had a heart problem but my doctor said it was pleurisy. Can you tell me what exactly this is?
The pleura is a thin, transparent, double-layered membrane that covers the lungs and the inside of the chest wall.
Between the two layers there is a small amount of fluid that helps lubricate them, assisting them to slide smoothly over one other when we breath. Pleurisy is an inflammation of the pleura which can develop when a virus or bacterium irritates the linings.
However, it can also be caused by a number of other factors such as drug reactions, injury, pneumonia, tuberculosis and cancer. The condition's most common symptom is chest pain which usually begins suddenly. Called pleuritic pain, it can vary from vague discomfort to an intense stabbing pain. It may be felt only when the person coughs or breathes deeply, while in others it may be felt continuously with a worsening on coughing.
The pain is not restricted to one location; I also have it in my stomach and shoulder. Is this normal with pleurisy?
Although pleuritic pain is often felt over the site of the inflammation, it is common to experience pain in the upper abdomen and also in the neck or shoulder as pain referred from the pleura.
My doctor said I had pneumonia and then developed pleurisy from this. But he listened only to my chest and did not send me for a chest X-ray. I would have thought an X-ray would be needed to make a diagnosis.
Pleurisy is easily diagnosed because of the nature of its distinctive pain. In addition, the use of a stethoscope allows the doctor to hear a squeaky rubbing noise, called a pleural rub. Once he hears this characteristic sound the diagnosis is almost certain. In addition, pleurisy does not always show up on an X-ray unless there is fluid visible between the pleura. The treatment of pleurisy will depend on its cause. If a bacterial cause is suspected then antibiotics will be prescribed.
However, if a virus is thought to be the cause then antibiotics will be of little use. Anti-inflammatory drugs help relieve the pain of pleurisy. Coughing may be eased if you hold a pillow to the area that hurts. Bed rest and fluids will help restore you to full health.
Marion Kerr