I've been sick twice in the past two years with severe chest pain. The first time, I went to my GP with chest pain and a cough. The second time, which occurred just recently, I didn't have a cough, just chest pain, and I went to the Emergency Department. Both
times I was told it was pleurisy. Can you explain this to me? And how can I prevent it? - Puzzled
Pleurisy is a weird condition. It's usually very minor, but its symptoms can easily be mistaken for a heart attack.
There are no accurate tests to confirm it, and usually no way to prevent it. Treatment is not very effective, and the condition can recur. The only good things are that it usually goes away in about a week or two, and doesn't cause any lasting trouble.
Pleurisy, or pleuritis, refers to an inflammation of the lining on the outside of the lung and/or the inside of the chest wall. It's usually caused by a virus, sometimes the very same ones that cause the common cold.
Typical symptoms are sharp chest pain that worsens with deep breathing, a dry cough, shortness of breath and sometimes a fever. Picture a sore spot inside your ribs being rubbed by your lung as it inflates and deflates, again and again. That, in a nutshell, is pleurisy.
But pleurisy can be tricky, causing a dull aching pain, or a pain that doesn't vary with breathing, or a pain that's not associated with any other symptoms of infection. In these cases doctors try to rule out the more serious causes: heart attacks, pulmonary emboli (blood clots in the lungs), pneumonia and pericarditis (inflammation of the sac that contains the heart). That's not always easy or clear-cut, and we often caution patients with pleurisy to return if they develop high fevers, worse pain, or new symptoms. Chest pain in any adult is a high-stakes symptom, and one that doctors (and patients) can sometimes misinterpret. And though we can't test everyone for everything, we can advise people to get checked out again if they're just not feeling right about their diagnosis.