Pleuritic chest pain

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Pleuritic chest pain is a syndrome characterized by piercing pain that is aggravated by breathing. It is important to note that the pleura is the lining around the lungs while the pleural fluid is responsible for lubricating its 2 layers.

Once there is buildup of excess fluid in these 2 layers of the pleura, pleuritic chest pain occurs. When the pleural tissues become inflamed, it results to intense chest pain that worsens while breathing. Other symptoms that might be present include chest tenderness, cough and shortness of breath.

Pleuritic chest pain
Chest pain that is aggravated by breathing is an indication of pleuritic chest pain.

What are the usual causes?

  • Bacterial or viral infections
  • Heart failure
  • Inhalation of toxic chemicals in the workplace
  • Pulmonary embolism
  • Lupus or rheumatoid arthritis
  • Pneumothorax
  • Mesothelioma
  • Abdominal conditions such as gallbladder disease or liver cirrhosis
  • Chest trauma

Characteristics of pleuritic chest pain

  • Chest pain that is aggravated by breathing
  • Stabbing sensation in the chest
  • Shortness of breath


The treatment of choice for pleuritic chest pain involves external splinting of the chest wall along with pain medications to alleviate the pain. Aside from these measures, pinpointing the main cause and proper treatment can help in reducing the pain.

  • If infection is the cause, antibiotics are given by the doctor.
  • Drainage using a chest tube is usually indicated if there is pus within the pleural space.
  • In severe cases where there is significant amount of pus, decortication is performed. In this procedure, it allows examination of the pleural space using a thoracoscope and removal of pus and other debris from the pleural space.
  • In case the buildup of fluid is due to cancer, pleurodesis is performed.

Remember that pleuritic chest pain can be prevented in some instances, but it varies from one case to another.

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