pleurisy procedure preparation

Overview

Pleurisy (also called pleuritis) is inflammation (swelling) of the pleura, the two thin layers of tissue that surround your lungs and line your chest cavity. When these layers become inflamed, they can rub against each other, causing sharp chest pain, especially when you breathe or cough.

Pleurisy is relatively common, especially in people who have viral respiratory infections. It can occur at any age but is more common in adults.

Pleurisy can affect anyone, but it is more common in adults. People with certain medical conditions, such as autoimmune disorders (like lupus), lung infections (like pneumonia), or a history of chest trauma, may be at higher risk.

Symptoms

Common symptoms

• Sharp chest pain that worsens with deep breathing, coughing, or sneezing
• Shortness of breath
• Dry cough
• Fever and chills (if related to infection)

Symptoms in children

• Irritability and fussiness
• Favoring one side (lying on the painful side)
• Rapid breathing
• Chest pain that may be described as 'stabbing' or 'pulling'

Symptoms in older adults

• Dull, less specific chest pain that may not be as sharp
• Confusion or dizziness (if infection spreads)
• Increased difficulty breathing
• Fatigue and weakness

Causes

Main causes

• Viral infections (like the flu or COVID-19)
• Bacterial infections (like pneumonia or tuberculosis)
• Autoimmune diseases (like lupus or rheumatoid arthritis)
• Chest injury or trauma
• Blood clot in the lung (pulmonary embolism)
• Cancer that spreads to the pleura (such as lung cancer or lymphoma)

Risk factors

• Having a recent respiratory infection
• Smoking or exposure to secondhand smoke
• Having an autoimmune disorder
• Being on medications that suppress the immune system
• Having a history of asbestos exposure (rare but possible)

When to see a doctor

See a doctor urgently if:

• If you have sharp chest pain that makes it hard to breathe
• If you have a high fever that doesn't improve
• If you cough up blood or notice blue lips

Book a routine appointment if:

• If you have a cough that lasts more than a week
• If you have mild chest pain that does not go away after a few days
• If you have a history of autoimmune disease and develop chest pain

Diagnosis

Your doctor will ask about your symptoms and medical history, listen to your chest with a stethoscope (they may hear a 'pleural rub' sound), and order tests to find the cause.

Tests that may be done

• Chest X-ray: to see if there is fluid or infection
• Blood tests: to check for infection or autoimmune markers
• Ultrasound: to look for fluid between the pleura layers
• CT scan: detailed images of the chest
• Thoracentesis: a procedure to remove a sample of pleural fluid for testing (if fluid is present)

What to expect at your appointment

If your doctor suspects pleurisy, they may recommend a procedure like thoracentesis. Before the procedure, you will be given a local anaesthetic to numb the area. A thin needle is inserted through your back to remove fluid. This helps with diagnosis and can also relieve symptoms. You may be asked to stop taking certain medications (like blood thinners) before the procedure. Your healthcare team will give you clear instructions.

Treatment

Treatment for pleurisy focuses on relieving symptoms and treating the underlying cause. Many people recover with rest and over-the-counter pain relief, but some require medications or procedures.

Self-care at home

• Rest until symptoms improve
• Take over-the-counter pain relievers (ask your pharmacist for options)
• Apply warm compresses to the chest for comfort
• Avoid smoking and secondhand smoke

Medical treatments

Your doctor may recommend anti-inflammatory medications or antibiotics if an infection is found. For pain that is not controlled, they may prescribe stronger pain relief. In some cases, medication to suppress the immune system is used for autoimmune causes. Always follow your doctor's advice on treatment.

When is surgery considered?

Surgery is rarely needed for pleurisy. However, if there is a lot of pus (empyema) or a collapsed lung, a drainage procedure or surgery to remove the infected tissue may be necessary.

Living with this condition

If you have pleurisy, you may need to take it easy for a few days to weeks. Avoid deep breaths that cause pain, but try to take gentle shallow breaths to prevent complications. Your doctor will tell you when you can return to normal activities.

Lifestyle tips

• Stop smoking if you smoke
• Avoid exposure to chemicals or fumes that irritate your lungs
• Get enough rest and sleep
• Stay up to date with vaccines that prevent respiratory infections

Diet and exercise

Eat a balanced diet to support your immune system. Gentle movement, like walking, can help maintain lung function, but avoid strenuous exercise until cleared by your doctor.

Mental health and emotional wellbeing

Living with chest pain and breathing difficulties can be stressful. It's normal to feel anxious or worried. Talk to your healthcare provider if you need support. If you feel overwhelmed, reach out to a mental health professional.

Prevention

Pleurisy itself cannot always be prevented, but you can lower your risk by taking steps to avoid infections and managing chronic conditions.

Vaccines

Getting vaccinated against the flu and pneumonia can help prevent some of the infections that lead to pleurisy.

Screening programmes

Screening is not usually done for pleurisy, but if you have a condition that increases your risk, your doctor may monitor you.

Complications

If left untreated

• Scarring or thickening of the pleura
• Pleural effusion (build-up of fluid around the lung)
• Empyema (collection of pus in the pleural space)
• Collapsed lung (pneumothorax)

Long-term outlook

With proper treatment, most people recover fully from pleurisy. The outlook depends on the underlying cause. For example, viral pleurisy often resolves on its own within a few weeks. Even if a procedure like thoracentesis is needed, the recovery is usually good. Your healthcare team will guide you through every step.

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