pleurisy screening test preparation

Overview

Pleurisy (pronounced PLUR-iss-ee) is a condition where the thin lining around your lungs (called the pleura) becomes swollen and painful. This lining normally helps your lungs move smoothly when you breathe, but when it's inflamed, it can cause sharp chest pain.

Pleurisy is not extremely common, but it does happen fairly often in people who have a lung infection, such as pneumonia. It is more likely in adults than in children.

Pleurisy can affect anyone, but it is most common in people who are already sick with a respiratory infection, have an autoimmune disease (like lupus or rheumatoid arthritis), or have had a chest injury or surgery.

Symptoms

Common symptoms

• Sharp chest pain that worsens when you breathe deeply, cough, sneeze, or move
• Pain that may spread to your shoulder or back
• Shortness of breath – you may feel like you cannot get enough air
• A dry cough
• Fever and chills (if an infection is present)

Symptoms in children

• Irritability or fussiness – your child may be uncomfortable and cry more than usual
• Rapid or shallow breathing – you may notice their chest moving faster than normal
• Complaints of chest or belly pain
• Refusing to eat or drink

Symptoms in older adults

• Less typical chest pain – it may feel dull or be hard to describe
• Confusion or being less alert than usual
• Fatigue and weakness without obvious cause
• Fever that might be low-grade or absent

Causes

Main causes

• Viral infections, such as influenza, the common cold, or COVID-19
• Bacterial infections, like pneumonia or tuberculosis
• A blood clot in the lung (pulmonary embolism)
• Chest injury, such as a broken rib or surgery on the chest
• Autoimmune diseases, for example lupus or rheumatoid arthritis

Risk factors

• Having a recent lung infection, like pneumonia or bronchitis
• Having an autoimmune condition that causes inflammation throughout the body
• Having had chest surgery or a chest injury
• Being a smoker or exposed to secondhand smoke
• Having cancer that has spread to the lungs or the lining around them

When to see a doctor

See a doctor urgently if:

• You have chest pain that is severe or comes on suddenly
• Your breathing becomes difficult or painful
• You cough up blood

Book a routine appointment if:

• You have a mild or moderate chest pain that lasts more than a few days
• You also have a fever, chills, or a cough that does not go away
• You feel generally unwell and are worried about your breathing

Diagnosis

Your doctor will start by asking about your symptoms, listening to your chest with a stethoscope, and pressing gently on your ribs. They may order tests to confirm pleurisy and find out what is causing it.

Tests that may be done

• Chest X-ray – a quick, painless image of your lungs and chest to look for fluid, infection, or other problems
• Blood tests – to check for signs of infection or inflammation in your body
• Ultrasound of the chest – uses sound waves to see if fluid has built up between the layers of the pleura
• CT scan (computed tomography) – a series of detailed X-ray pictures that give a clearer view of the lungs and pleura

What to expect at your appointment

Most of these tests are done in a hospital or clinic and are not painful. For a chest X-ray or CT scan, you will need to lie still while the machine takes pictures. An ultrasound uses a small hand-held device that is moved over your skin. Your doctor will tell you if you need to prepare in any special way, such as wearing loose clothing or not eating before a test. Usually, you can go home the same day.

Treatment

Treatment for pleurisy focuses on easing the pain and treating the underlying cause, such as an infection or an autoimmune condition. Most people recover fully with the right care.

Self-care at home

• Rest as much as possible – your body needs energy to fight the inflammation
• Use a warm compress or a heating pad on your chest for short periods to help relieve pain
• Take slow, shallow breaths or try breathing exercises to avoid making the pain worse
• Avoid smoking and secondhand smoke, as they can irritate your lungs

Medical treatments

Depending on what is causing the pleurisy, your doctor may recommend medications to reduce inflammation and pain. If a bacterial infection is the cause, antibiotics will be prescribed. For viral infections, treatment is usually focused on symptom relief. If an autoimmune disease is involved, steroids or other medications that calm the immune system may be used. Your doctor will choose the safest option for you.

When is surgery considered?

Surgery is rarely needed for pleurisy. In very severe cases where a large amount of fluid or pus builds up around the lung, a procedure to drain the fluid may be necessary. This is usually done by inserting a small tube through the chest wall. You will be given medicine to keep you comfortable during the procedure.

Living with this condition

While you have pleurisy, you may need to take it easy and avoid activities that make your chest hurt, like heavy lifting or intense exercise. Most people feel better within a few days to a couple of weeks. Once the pain is gone, you can slowly return to your normal routine.

Lifestyle tips

• Quit smoking if you smoke – smoking worsens inflammation and delays healing
• Avoid exposure to air pollution, dust, and strong chemical fumes
• Try to get plenty of rest, especially in the first few days

Diet and exercise

Eat a balanced diet with plenty of fruits, vegetables, and whole grains to support your immune system. Stay hydrated by drinking water. Gentle exercise, such as walking, can be resumed once your chest pain improves, but listen to your body and stop if you feel pain. Ask your doctor when it is safe to start exercising again.

Mental health and emotional wellbeing

Dealing with chest pain and worry about your breathing can be stressful and even frightening. It is normal to feel anxious or down while you are unwell. Talk to your healthcare team about how you are feeling – they can offer support or refer you to a counselor if needed.

Prevention

You cannot always prevent pleurisy, but you can reduce your risk by treating infections early, getting vaccinated against the flu and pneumonia, and avoiding chest injuries. If you have an autoimmune condition, working closely with your doctor to manage it may help lower your chance of developing pleurisy.

Vaccines

Getting the flu vaccine every year and the pneumonia vaccine as recommended by your doctor can help prevent some infections that lead to pleurisy.

Screening programmes

There is no routine screening test for pleurisy. It is usually diagnosed when you see a doctor because of symptoms.

Complications

If left untreated

• Pleural effusion – a buildup of fluid around the lung that can make breathing more difficult
• Empyema – an infection that causes pus to collect in the pleural space, which may require drainage or surgery
• Scarring or thickening of the pleura (pleural thickening) – this can limit lung movement and cause long-term breathlessness

Long-term outlook

With the right treatment, most people recover from pleurisy without any lasting problems. Even if complications occur, they can often be managed successfully. If you follow your doctor's advice and take care of yourself, you have a very good chance of getting back to your normal health.

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