Pleurisy Center


Pleuritis, or pleuritic chest pain accounts for over half a million short-stay hospital discharges each year in the U.S. But what is pleurisy? And what happens to the lungs during this condition?

Lung anatomy
The lungs are organs located in the chest that facilitate gas exchange during breathing. During gas exchange, the lungs take in oxygen from the air and remove carbon dioxide from the body, a vital function of life that helps the body work properly.

The pleura are large, thin sheets of tissue that wrap around the outside of the lungs and lines the inside of the chest cavity. The double-layered pleura protect and lubricate the surface of the lungs as they inflate and deflate within the rib cage. Between the layers of the pleura is a very thin space which is filled with a small amount of fluid. The fluid helps the two layers of the pleura glide smoothly past each other as the lungs breathe air in and out.

What is pleurisy?
Pleurisy is the medical term for inflammation or swelling of the pleura, the double-layered membrane that surrounds each lung and the rib cage. During cases of pleurisy, the normally smooth lining of the lung (the pleura) become rough. The two layers of the pleura become red and inflamed and rub against each other every time the lungs expand to breathe in air. This causes a characteristic rough, grating sound called “friction rub.” The condition can cause sharp pain with breathing and is a potentially serious condition that can have long-term effects.

Types of pleurisy
Pleurisy cases are also characterized by either pleural effusion (an accumulation of fluid in the pleural space) or as being dry. Dry pleurisy refers to cases where there is no fluid build-up. Pleural effusion is the more common condition of the two, is less painful due to the fluid forcing some separation of the membranes. However, the fluid puts pressure on the lungs which can lead to respiratory distress and even lung collapse.

Dry pleurisy - During this inflammation of the pleura, no fluid is present between the surface of the lungs and the rib cages. Dry pleurisy can be very painful, especially when the swollen outer layer of the pleura stretches during breathing. Dry pleurisy may recede, even though roughened tissues may still be senses. Or dry pleurisy may develop into wet pleurisy, with the accumulation of fluid. The fluid may be absorbed and become a dry pleurisy again.

Wet pleurisy / pleural effusion - In some cases of pleurisy, excess fluid builds up in the pleural space. This is called a pleural effusion. The buildup of fluid usually forces the two layers of the pleura apart so they don't rub against each other when you breathe. This can relieve your pain. However, a large amount of extra fluid can push the pleura against your lung until the lung, or a part of it, collapses. This can make it hard for you to breathe. In some cases of pleural effusion, the extra fluid gets infected and turns into an abscess. However, you can develop a pleural effusion if you don't have pleurisy. For example, pneumonia, heart failure, cancer, injury of the thoracic duct or a pulmonary embolism can lead to a pleural effusion.

Other types of pleura disorders

Chylothorax - This condition appears during injury to the thoracic duct, which contains lipids and lymph.

Hemothorax - During this condition, blood collects in the pleural space. The most common cause of a hemothorax is injury the chest from blunt force or chest or heart surgery, but can occur in people with lung or pleural cancer. Hemothorax can put pressure on the lung and force it to collapse or cause shock.

Pneumothorax - During this condition, air or gas builds up in the pleural space. This can result from acute lung injury, lung disease or lung procedures (surgery, drainage of fluid with a needle, mechanical ventilation, etc.) If the pneumothorax is small, it may go away on its own. If it's large, doctors may need to remove the air to prevent pressure on the lung which can cause it to collapse.

Although viral infections cause most types of pleurisy, many other causes exist. But what are these? And are only older people diagnosed with pleurisy? Continue reading here for more information on risk factors and causes of pleurisy.

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