Is it normal to occasionally have chest pain with pleurisy?

Written by Wang Chun Mei
Pulmonology
Updated on September 10, 2024
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Pleurisy is a very common type of disease, with many triggering factors. Most cases of pleurisy are caused by infection of the pleural cavity by Mycobacterium tuberculosis, leading to inflammatory lesions. Once pleurisy is diagnosed, patients should promptly receive anti-tuberculosis medication for effective treatment. It is commonly known that if pleurisy is not controlled promptly and effectively, it may lead to worsening symptoms such as cough, fever, shortness of breath, chest tightness, and chest pain, so these clinical symptoms are also very common in patients with pleurisy. Therefore, it is very common for patients with pleurisy to experience chest pain. Even after complete recovery from pleurisy, there may be varying degrees of chest pain, which is considered normal. This is because pleurisy in the acute phase may involve different degrees of adhesions, hence chest pain may occur later on as well.

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Written by An Yong Peng
Pulmonology
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What are the symptoms of pleurisy?

Common symptoms of pleurisy include chest pain, which often worsens with deep breathing. This condition is also called pleuritic chest pain. It is important to note that the presence of such chest pain does not necessarily indicate pleurisy; it could also be due to pneumonia, pulmonary embolism, or even rib fractures. Patients with pleurisy may also experience a sensation of chest tightness, especially when there is a significant amount of pleural effusion. Furthermore, severe chest pain caused by pleurisy may lead to patients avoiding deep breaths, which can also result in symptoms of chest tightness. Fever is another common symptom in patients with pleurisy, and the severity of fever can vary depending on the infection causing the pleurisy. For example, tuberculous pleurisy, caused by tuberculosis infection, often results in a low-grade fever in the afternoon, but high fevers can also occur. In the case of purulent pleurisy, which is usually due to a bacterial infection leading to pus formation in the pleural cavity, high fevers are common.

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Written by Li Hu Chen
Imaging Center
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Post-pleurisy chest X-ray presentation

Patients with pleurisy, after their recovery, often exhibit certain signs on chest X-rays, such as thickening and adhesion of the pleura, and blunting of the costophrenic angle. These conditions commonly arise because diseases like pleurisy might have a somewhat extended duration or are not detected timely, lacking prompt medical treatment. Hence, pleural thickening is prone to occur, visible on X-rays at the lung margins, where localized soft tissue density appears slightly thicker. Normally, the edge of the lung at the costophrenic angle would be quite sharp, but after pleural thickening, this angle becomes blunted or even rounded. In some cases, encapsulated effusions might be seen on a chest X-ray as a spindle-shaped high-density shadow near the chest wall, which appears as a notably bright shadow.

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Written by Yuan Qing
Pulmonology
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What should I do about pleurisy calcification?

Pleural calcification, mainly results from long-term unresolved pleuritis or inadequate timely treatment, causing adherence between the two pleural layers. Following this adhesion, calcium salts may deposit, leading to calcification. Usually, the primary consideration is whether the patient's lung function has been impacted. If so, a thoracotomy and pleural decortication might be performed to restore the pleural structure. If the patient only shows pleural calcification on imaging without significant discomfort, it may be observed without immediate intervention, and regular monitoring of the calcification is recommended to see if it enlarges. If the condition remains stable over time, it might not require treatment since this represents a tendency towards healing, or the residual scarring may not necessitate special management.

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Written by Wang Chun Mei
Pulmonology
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Is it normal to occasionally feel chest tightness with pleuritis?

Patients with pleurisy occasionally experience chest tightness, which is a very common clinical symptom. It is important to clarify that in clinical cases, pleurisy is mostly due to infection of the pleural cavity by Mycobacterium tuberculosis, causing clinical symptoms such as fever, chest tightness, shortness of breath, cough, and chest pain. Therefore, during an acute episode of pleurisy, some patients may have a severe pleural infection, and possibly a large amount of pleural effusion, which inevitably leads to symptoms like shortness of breath and chest tightness. For patients with pleurisy, if it is tuberculous, it is crucial to provide anti-tuberculosis medication as early as possible for symptomatic treatment. A lengthy course of treatment is usually required to effectively control the discomfort caused by pleurisy.

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Written by Wang Chun Mei
Pulmonology
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What causes pleurisy in young people?

In clinical practice, populations with pleurisy are often common among young people and children. The factors inducing pleurisy in young people are mainly due to low immune function and the presence of pathogenic factors that stimulate an inflammatory response in the pleura. Such patients often experience infections, with tuberculosis infections being more common. This often leads to clinical symptoms such as chest pain, chest tightness, shortness of breath, coughing, wheezing, and even difficulty breathing. Therefore, for individuals with low immune function, it is particularly important to pay attention to strengthening nutrition and to balance work and rest. When the body's functions are weakened, it is necessary to properly enhance nutrition and exercise to improve the body's immunity and reduce the likelihood of developing pleurisy.