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 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.

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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.

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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 Wang Chun Mei
Pulmonology
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Can pleurisy cause hemoptysis?

Pleurisy, this disease in clinical practice, does not cause symptomatic hemoptysis on its own. This is because pleurisy is mainly due to bacterial invasion into the pleural cavity causing inflammatory lesions. The pleural cavity is a sealed space, which, when inflamed, often causes symptoms such as fever, cough, chest tightness, shortness of breath, and breathing difficulties when there is a significant accumulation of fluid in the chest cavity. Generally, it does not cause hemoptysis. There is only one possibility, for example, intense irritative coughing in patients with pleurisy may rupture the capillaries in the bronchial walls. In this case, patients might experience varying degrees of coughing with blood, but this is not a direct clinical symptom caused by pleurisy itself.

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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.