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This topic provides information about pleurisy, which usually results in chest pain. If you have chest pain that concerns you and that your doctor does not know about, see the topic Chest Pain.

What is pleurisy?

Pleurisy is swelling (inflammation) of the thin layers of tissue (pleura) covering the lungs and the chest wall.

The outer layer of the pleura lines the inside of the chest wall, and the inner layer covers the lungs. The tiny space between the two layers is called the pleural cavity. This cavity normally contains a small amount of lubricating fluid that allows the two layers to slide over each other when you breathe.

When the pleura becomes inflamed, the layers rub together, causing chest pain. This is known as pleuritic pain.

Pleurisy is sometimes called pleuritis.

What causes pleurisy?

In young, healthy people, an infection of the lower respiratory system by a virus or bacteria may cause pleurisy. Pleurisy usually lasts a few days to 1 or 2 weeks. In very rare cases, the virus or bacteria may spread and cause pleurisy in others.

Other causes of pleurisy include air leaking into the pleural cavity from a lung (pneumothorax), injury to the chest (such as a broken rib), tuberculosis or other infections, or a tumor in the pleura.

Other conditions may also cause pleurisy. These include rheumatoid arthritis, lupus, sickle cell crisis, pulmonary embolism, or pancreatitis. Pleurisy may also develop as a complication of heart surgery.

What are the symptoms of pleurisy?

The symptoms of pleurisy are chest pain and difficulty breathing. The chest pain usually starts suddenly. People often describe it as a stabbing pain and it usually gets worse with breathing. The pain:

• May always be present, but it usually gets worse when you breathe in. You may avoid breathing deeply to prevent the pain.
• Usually is on only one side of the chest.
• May extend to a shoulder or the belly.
• Is usually worse when you cough, sneeze, or suddenly move.
• May ease when you hold your breath or press on the painful area.

But this type of chest pain can be caused by conditions that do not affect the pleura, such as chest muscle strain and costochondritis.

If a viral infection is causing your pleurisy, you may or may not have common viral symptoms, such as fever, headache, and muscle aches.

The inflammation of the pleura sometimes causes fluid to build up in the pleural cavity (pleural effusion). You may have less pain after this happens, because the fluid prevents the two layers of the pleura from rubbing together. If there is a large amount of fluid, it may prevent the lung from expanding when you breathe in. This can make it hard to breathe. Other symptoms of pleural effusion include fever, chest pain, and a dry cough.