Is it normal to occasionally feel chest tightness with pleuritis?

Written by Wang Chun Mei
Pulmonology
Updated on September 08, 2024
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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 Shen Jiang Chao
Radiology
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Can pleurisy be seen on a chest X-ray?

Pleurisy can also be detected in chest radiographs, but it depends on the type. There are two types of pleurisy: dry and wet. Dry pleurisy cannot be clearly identified, while wet pleurisy, which is mostly caused by tuberculosis, can show more typical characteristics. Tuberculous pleurisy primarily manifests as pleural effusion. A small amount of pleural effusion on an X-ray appears as blunting of the costophrenic angle on the same side and blurring of the diaphragm. A moderate amount of pleural effusion is shown on the chest radiograph as a uniformly consistent high-density shadow on the same side, which appears higher on the outside and lower on the inside, with an arc-shaped shadow. The muscle costophrenic angle and diaphragm are obscured. A large amount of pleural effusion presents as a high-density shadow in the pleural cavity on the same side, with the mediastinal cardiac silhouette clearly shifting to the interlateral side.

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Written by Liu Jing Jing
Pulmonology
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Is pleurisy ascites easy to treat?

Whether pleurisy with effusion is easy to treat depends on identifying the cause of the pleurisy, which commonly includes tuberculosis, infection, and tumors. Tuberculous pleurisy can usually be cured about six months to a year after standard anti-tuberculosis treatment; infectious pleurisy generally has a good prognosis if it is sensitive to anti-infective drugs; however, pleurisy caused by tumors often indicates metastasis to the pleura, and at this stage, surgical options are no longer viable, leading to a poor prognosis. Therefore, if pleurisy is present, it is necessary to go to the hospital to complete thoracic puncture and clarify the nature of the pleural effusion, and treat according to the cause.

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Written by Wang Chun Mei
Pulmonology
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Does pleural calcification easily turn into cancer?

Pleurisy is a very common type of inflammatory lesion clinically. There are many factors that cause pleurisy, and it is generally seen in young and middle-aged males, mainly caused by Mycobacterium tuberculosis infection of the pleural cavity. If the pleurisy is tuberculous, it is usually treated with effective anti-tuberculosis medications systematically, which typically requires a course of 6 to 9 months. After complete recovery from pleurisy, many patients may show varying degrees of calcification spots in the pleural cavity. Generally, these calcification spots after recovery from pleurisy do not easily become cancerous.

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Written by Yuan Qing
Pulmonology
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Is pleurisy calcification dangerous?

Pleural calcification generally poses no major danger. It is typically a result of incomplete treatment of pleuritis or prolonged illness that delays the disease management, causing the disease to progress and the pleura to develop adhesions, leading to the deposition of calcium salts on the pleura and resulting in calcification. Depending on the extent of this pleural calcification, if severe, it may affect lung expansion and thereby reduce respiratory function. However, most cases do not exhibit significant symptoms. Moreover, it does not greatly impact the patient's life or quality of life. Therefore, when such calcification is observed, it is generally recommended that the patient be advised to attend regular follow-up checks. It does not necessarily cause any special symptoms, so there is no need for concern.

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Written by Wang Chun Mei
Pulmonology
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Is it normal to have pain in the later stages of pleurisy?

Pleurisy is very common in clinical settings, caused by various pathogens invading the pleural cavity, leading to an inflammatory response. Most pleurisy patients are mainly afflicted due to infections by the tuberculosis bacillus, thus pleurisy typically comes with varying degrees of effusion, leading to different degrees of adhesion in the pleural cavity. Therefore, even during the acute phase of pleurisy, patients may suffer from symptoms such as coughing, fever, chest pain, breathlessness, and difficulty breathing. Even after effective medicinal treatment of pleurisy and full recovery, patients may still experience varying degrees of chest pain later on, primarily due to various degrees of pleural adhesion. During physical exertion or coughing, this can lead to varying degrees of chest pain, a very common occurrence.