Pleurisy: Symptoms, diagnosis and treatment

Pleurisy: Symptoms, diagnosis and treatment

What is pleurisy?

Pleurisy also called pleuritis, is an inflammation of the Pleura, which is the moist, double-layered membrane that surrounds the lungs and lines the inside of the rib cage. The condition can make breathing extremely painful. Sometimes it is associated with another condition called pleural effusion, where excess fluid fills the area between the membrane's layers.

The double-layered pleura protects and lubricates the surface of the lungs as they inflate and deflate within the rib cage. Normally, a thin, fluid-filled gap - the pleural space - allows the two layers of the pleural membrane to slide gently past each other. But when these layers become inflamed, with every breath, sneeze or cough their roughened surfaces rub painfully together like two pieces of sandpaper.
In some cases of pleurisy, excess fluid seeps into the pleural space, resulting in pleural effusion. This fluid build-up usually has a lubricating effect, relieving the pain associated with pleurisy as it reduces friction between the membrane's layers. But at the same time, the added fluid puts pressure on the lungs, reducing their ability to move freely. A large amount of fluid may cause shortness of breath. In some cases of pleural effusion, this excess liquid can become infected.

What causes pleurisy?

Viral infection is probably the most common cause of pleurisy. Other causes include the following:

• Lung infections, such as pneumonia and tuberculosis
• Diseases such as systemic lupus erythematosus (lupus), rheumatoid arthritis,cancer liver diseases and pulmonary embolism
• Chest injuries
• Drug reactions

Pleurisy and pleural effusion are generally only as serious as the underlying disease causing it. If you have either of these conditions, you may already be undergoing treatment for the underlying disease; if not, seek medical attention immediately.
A pleural effusion can occur without pleurisy. Kidney disease, heart failure and liver disease can cause pleural effusion without inflammation or pain.

What are the symptoms of pleurisy?

Symptoms of pleurisy include the following:

• Severe, fleeting, sharp pain in your chest, often only on one side, when breathing deeply, coughing, moving, sneezing or even talking.
• Severe chest pain that goes away when you hold your breath.
• When pleurisy occurs in certain locations on the lungs, the pain can be felt in other parts of the body such as the neck, shoulder or abdomen.
• Rapid, shallow breathing in response to the pain.

Seek medical advice if you have even a slight fever with these symptoms. Fever could be a sign of a lung infection.

What are the symptoms of pleural effusion?

The symptoms of pleural effusion include:

• Shortness of breath
• A dry cough

Seek medical advice about pleurisy if:

• You are experiencing pleurisy symptoms, particularly if you have not been diagnosed with an underlying disease that could be causing this lung condition; pleurisy and pleural effusion can be symptoms of serious diseases such as pneumonia and lung cancer.
• You experience symptoms accompanied by fever, no matter how slight. You may have a type of infection that requires treatment with antibiotics.

Causes of liquids in lungs

   Pulmonary Edema

Pulmonary Edema or abnormal accumulation of liquid in the lungs is a serious condition because it affects breathing; and may lead to death. As fluid fills into the lungs, the tiny alveoli sacs responsible for oxygen and carbon dioxide exchange become filled thereby disrupting normal breathing. Symptoms of pulmonary edema include shortness of breath, coughing, wheezing, anxiety, excessive sweating and Tachycardia or fast heartbeat, according to the University of Illinois Medical Center. Other symptoms that are more serious include coughing up blood, decreased alertness, nasal flaring and inability to speak full sentences.

Cardiac Cause

According to the Mayo Clinic website Mayo Clinic.com, whenever the left ventricle or heart chamber does not function properly, it usually causes edema. Several conditions can cause the left ventricle to weaken or fail thereby backing up blood flow. Coronary artery disease occurs when the arteries become clogged with plaque or fatty deposits and clots may form blocking the flow of blood to the heart. When blood does not reach the heart muscle, the tissue dies and becomes non-functional. Cardiomyopathy refers to heart damage due to several factors. One factor includes heredity whereby a family carries a defective gene leading to heart disease. Other causes include viral infections, drug and alcohol abuse. Heart valve problems also lead to edema when the valves do not work properly causing blood to flow backwards into the lungs. Finally, high blood pressure may also put pressure on the left ventricle by causing it to thicken.

Illness, Toxins and Drugs

Pulmonary edema may also have non-cardiac causes. Acute respiratory distress syndrome or A  R D S is a serious condition where the lungs fill up with fluid and become inflamed, says Mayo Clinic.com. This condition can result because of trauma, pneumonia, shock and infection. Kidney disease occurs when the kidneys are not functioning properly due to illness and are unable to remove excess fluid from the body. The fluid accumulation may fill the lungs. Inhalation of toxins like chlorine, ammonia and smoke may cause damage to membranes of the lungs resulting in fluid leakage into the air sacs. Drugs may also be responsible for pulmonary edema. This includes illegal drugs like cocaine and heroin as well as legal drugs like aspirin and chemotherapy.

High Altitude

High altitude pulmonary edema or H A P E is a serious condition caused by high altitude which puts pressure on the pulmonary capillaries or blood vessels, says Mayo Clinic.com. The condition occurs at elevations above 8,000 feet and affects mountain climbers, skiers, and hikers who do not acclimate themselves prior to physical activity. Acclimating to high altitudes should be done each time one is attempting any sort of activity.