Pleurisy

Also known as pleuritis, pleurisy is inflammation of the visceral and parietal pleurae that line the inside of the thoracic cage and envelop the lungs.

Pleurisy (PLOOR-iss-ee) is caused by swelling and irritation of the membrane that surrounds the lungs. It is usually a symptom of another illness. It is also called Pleuritic Chest Pain. Pleurisy occurs as a complication of a wide variety of underlying conditions. Relieving pleurisy involves treating the underlying condition, if it's known, and taking pain relievers.

Causes

The underlying medical conditions that can cause pleurisy are numerous. They include:

• An acute viral infection, such as the flu (influenza)
• Pneumonia, in those cases in which the infected portion of the lung involves the pleural surface
• Autoimmune conditions such as lupus, rheumatoid arthritis and autoimmune hepatitis
• Tuberculosis and other infections
• A clot in an artery of your lungs (pulmonary embolism)
• Pancreatitis

Pleurisy can also occur as a result of trauma to your chest or after heart surgery. In some cases, the cause is unknown (idiopathic).

Signs and symptoms

The hallmark of pleurisy is severe chest pain that starts suddenly. The pain is often strong or stabbing when you take a deep breath. It usually subsides or disappears between breaths. It's usually felt on one side of the stomach area or lower chest. Deep breathing and coughing often make it worse. You may also have a fever, pain when moving, or fast, shallow breathing. Typically, you will be able to point to the exact location of the pain. In some people, the pain spreads to the neck, shoulder, or abdomen.

Diagnosis

Auscultation of the chest reveals a characteristic pleural friction rub-a coarse, creaky sound heard during late inspiration and early expiration, directly over the area of pleural inflammation. Palpation over the affected area may reveal coarse vibration.

Treatment

Generally symptomatic treatment includes anti-inflammatory agents, analgesics, and bed rest. Severe pain may require an intercostal nerve block of two or three intercostal nerves. Pleurisy with pleural effusion calls for thoracentesis as both a therapeutic and a diagnostic measure.

Alternative treatment

Alternative treatments can be used in conjunction with conventional treatment to help heal pleurisy. Acupuncture and botanical medicines are alternative approaches for alleviating pleural pain and breathing problems. An herbal remedy commonly recommended is pleurisy root (Asclepias tuberosa), so named because of its use by early American settlers who learned of this medicinal plant from Native Americans.

Traditional Chinese medicine uses the herb ephedra (Ephedra sinica), which acts to open air passages and alleviate respiratory difficulties in pleurisy patients. Dietary recommendations include eating fresh fruits and vegetables, adequate protein, and good quality fats (omega-3 fatty acids are anti-inflammatory and are found in fish and flax oil). Taking certain nutritional supplements, especially large doses of vitamin C, may also provide health benefits to people with pleurisy

Prevention

Preventing pleurisy is often a matter of providing early medical attention to conditions that can cause pleural inflammation. Along this line, appropriate antibiotic treatment of bacterial respiratory infections may successfully prevent some cases of pleurisy. Maintaining a healthy lifestyle and avoiding exposure to harmful substances (for example, asbestos) are more general preventative measures.