pleurisy specialist tests overview

Overview

Pleurisy is inflammation of the pleura, the thin tissue that lines your lungs and the inside of your chest wall. It causes sharp chest pain, especially when you breathe in or cough.

Pleurisy is not extremely common, but it is a well-known condition that can affect people of all ages.

It can affect anyone, but it is more likely in people with lung infections, autoimmune diseases, after chest surgery, or in those with a blood clotting disorder.

Symptoms

Common symptoms

• Sharp chest pain that worsens with breathing or coughing
• Shortness of breath
• Dry cough
• Fever and chills

Symptoms in children

• Chest pain that may be mistaken for stomach pain
• Irritability and crying
• Rapid breathing
• Fever

Symptoms in older adults

• Milder pain that may be harder to describe
• Confusion or fatigue
• Shortness of breath
• Fever may be lower than in younger people

Causes

Main causes

• Viral infection (most common)
• Bacterial pneumonia
• Autoimmune diseases (e.g., lupus, rheumatoid arthritis)
• Pulmonary embolism (blood clot in the lung)
• Chest injury or surgery
• Cancer near the pleura

Risk factors

• Recent lung infection or pneumonia
• Autoimmune disorder
• Blood clotting disorder
• Chest trauma or surgery
• Exposure to asbestos

When to see a doctor

See a doctor urgently if:

• If you have sharp chest pain and difficulty breathing
• If you have chest pain with fever and chills
• If you have unexplained chest pain that gets worse

Book a routine appointment if:

• If you have mild chest pain that lasts more than a few days

Diagnosis

Your doctor will listen to your chest with a stethoscope for a rubbing sound called a pleural rub. They may order tests to confirm pleurisy and find the cause.

Tests that may be done

• Chest X-ray – to look for fluid or infection in the lungs
• Blood tests – to check for infection or autoimmune markers
• Ultrasound of the chest – to see fluid buildup around the lungs
• CT scan – more detailed images of the lungs and pleura
• Thoracentesis – a needle is used to remove a sample of fluid from the pleural space for testing

What to expect at your appointment

You may have several tests in a clinic or hospital. Most are painless, though thoracentesis may cause mild discomfort. Results may take a few days.

Treatment

Treatment depends on the underlying cause. The main goal is to reduce inflammation and pain, and treat the cause.

Self-care at home

• Rest until symptoms improve
• Take over-the-counter pain relievers as recommended by your doctor
• Apply a warm compress to the chest for comfort

Medical treatments

Doctors may prescribe anti-inflammatory medications or treat infections with appropriate antibiotics. For autoimmune causes, they may use steroids or other medicines to calm the immune system. If a blood clot is found, blood thinning medicine may be given.

When is surgery considered?

Surgery is rarely needed for pleurisy. It may be considered if there is a large fluid collection that needs draining, or if the pleura is severely scarred.

Living with this condition

Once the underlying cause is treated, most people recover fully. During recovery, take it easy and avoid activities that make your chest hurt.

Lifestyle tips

• Avoid smoking and secondhand smoke
• Get plenty of rest
• Take pain relief as needed
• Follow up with your doctor

Diet and exercise

No special diet is needed, but eating well helps recovery. Gentle activity like walking can be resumed gradually as pain improves.

Mental health and emotional wellbeing

Chronic chest pain can cause anxiety or stress. If you feel overwhelmed, talk to your doctor or a counselor.

Prevention

You cannot always prevent pleurisy, but treating infections promptly and managing chronic conditions can lower your risk.

Vaccines

Getting vaccinated against flu and pneumonia may help prevent some causes of pleurisy.

Complications

If left untreated

• Pleural effusion (fluid buildup that can compress the lung)
• Empyema (infected fluid in the pleural space)
• Scarring of the pleura (fibrothorax) that restricts breathing
• Sepsis (infection spreading to the bloodstream)

Long-term outlook

With proper diagnosis and treatment, most people with pleurisy recover completely. The outlook depends on the underlying cause, which is often treatable.

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