Lung and Pleural Disease

Overview

Your pleura is a large, thin sheet of tissue that wraps around the outside of your lungs and lines the inside of your chest cavity. Between the layers of the pleura is a very thin space. Normally it's filled with a small amount of fluid. The fluid helps the two layers of the pleura glide smoothly past each other as your lungs breathe air in and out.

Disorders of the pleura include
. Pleurisy - inflammation of the pleura that causes sharp pain with breathing
. Pleural effusion - excess fluid in the pleural space
. Pneumothorax - buildup of air or gas in the pleural space
. Hemothorax - buildup of blood in the pleural space





Many different conditions can cause pleural problems. Viral infection is the most common cause of pleurisy. The most common cause of pleural effusion is congestive heart failure. Lung diseases, like COPD, tuberculosis, and acute lung injury, cause pneumothorax. Injury to the chest is the most common cause of hemothorax. Treatment focuses on removing fluid, air, or blood from the pleural space, relieving symptoms, and treating the underlying condition.



What Causes Pleural Disease?

Many conditions can cause pleurisy. Viral infections are likely the most common cause. Other causes of pleurisy include:

. Bacterial infections, such as pneumonia (nu-MO-ne-ah) and tuberculosis, and infections from fungi or parasites
. Pulmonary embolism, a blood clot that travels through the blood vessels to the lungs
. Autoimmune disorders, such as lupus and rheumatoid arthritis
. Cancer, such as lung cancer, lymphoma, and mesothelioma (MEZ-o-thee-lee-O-ma)
. Chest and heart surgery, especially coronary artery bypass grafting
. Lung diseases, such as LAM (lymphangioleiomyomatosis) or asbestosis (as-bes-TO-sis)
. Inflammatory bowel disease
. Familial Mediterranean fever, an inherited condition that often causes fever and swelling in the abdomen or lungs.

Other causes of pleurisy include chest injuries, pancreatitis (an inflamed pancreas), and reactions to certain medicines. Reactions to certain medicines can cause a condition similar to lupus. These medicines include procainamide, hydralazine, and isoniazid.




What Are the Symptoms of Pleural Disease?

The main symptom of pleurisy is a sharp or stabbing pain in your chest that gets worse when you breathe in deeply or cough or sneeze.

The pain may stay in one place or it may spread to your shoulders or back. Sometimes the pain becomes a fairly constant dull ache.

Depending on what's causing the pleurisy, you may have other symptoms, such as:
. Shortness of breath or rapid, shallow breathing
. Coughing
. Fever and chills
. Unexplained weight loss
. Sudden, sharp chest pain that gets worse when you breathe in deeply or cough
. Chest tightness
. Easy fatigue (tiredness)
. A rapid heart rate
. A bluish tint to the skin caused by lack of oxygen
. Respiratory failure
. Anxiety
. Restlessness