Usually the first sign of pleurisy is a distinctive chest pain that starts suddenly. The pain can vary from vague discomfort to an intense stabbing pain. Sometimes it is felt only while breathing deeply or coughing, or it can cause continuous pain that gets worse with deep breathing or coughing. Usually the pain is felt in the chest wall over the location of the inflammation, but it may also be felt in the upper abdominal area or in the neck and shoulder or in a combination of these areas.
Because inhaling deeply hurts, a patient with pleurisy tends to breathe rapidly and shallowly. On the side where the pain is, the muscles of the chest move less than those on the other side. If fluid builds up between the layers of the pleura, the chest pain may go away. Large quantities of fluid can make expanding one or both lungs difficult.
Other less common symptoms may include:
- Shortness of breath
- Rapid breathing
Causes and Risk Factors
Pleurisy is caused by inflammation of the pleura, two thin sheets of lining that wrap around the chest cavity and lungs. Normally, these two sheets of lining smoothly glide past one another with each breath. When irritation to the pleura occurs, this causes friction during breathing.
Irritation of the pleura can be caused by: