Pleurisy: the lung condition that mimics a heart attack

Pleurisy is inflammation of the membrane between your lungs and ribs, or pleura. The condition, which makes breathing both difficult and painful, often mimics the symptoms of a heart attack.

In a healthy body, the double-layered pleura lines the outside of the lungs and inside of the rib cage with a lubricating fluid in between its layers. When pleurisy happens, the tissue layers become inflamed and/or the fluid changes in consistency or amount.

Causes

Pleurisy is usually caused by a viral infection that starts as a cold. Other causes include:

• Lung infections, pneumonia, tuberculosis
• Other diseases such as systemic lupus, rheumatoid arthritis, cancer, liver diseases and pulmonary embolism
• Chest injuries
• Drug reactions

Pleurisy is generally only as serious as the condition that caused it. Most viral cases take time to heal, but they do get better.

In some cases of pleurisy, fluid builds up in the small space between the two layers of tissue, becoming a pleural effusion. When this extra fluid gets infected it's called an empyema, and is often accompanied by fever.

Symptoms

Deciphering the symptoms of pleurisy is complicated because they mimic those of a heart attack. Oftentimes, this creates anxiety, causing the symptoms to be more intense.

According to the Mayo Clinic, the symptoms of pleurisy include:

• Chest pain that worsens when you breathe, cough or sneeze
• Shortness of breath, because you will try to minimize breathing in and out to prevent pain
• Cough (in some cases)
• Fever (in some cases)

Treatments

Diagnosis and treatment for pleurisy is complicated, to say the least.

Treatment depends on the seriousness of the underlying disease that caused inflammation. If bacterial pneumonia is the cause, an antibiotic will control the infection; if the cause is viral, pleurisy will have to resolve on its own.

Pain medication is also a needed part of treatment, but it's important that the method of pain control does not reduce your activity or breathing.

"In the case of pleural effusion, your doctor will direct treatment towards the underlying cause of the fluid," WebMD editors write. "Sometimes, if the pleural fluid is infected or the amount is excessive, the doctor may drain it through a tube inserted in your chest, a procedure that requires hospitalization."

Unfortunately, this painful condition will not go away quickly, sometimes lasting up to several weeks. As you heal, get plenty of rest and eat well. If you do not take care of yourself the pleurisy pain will take care of you, so to speak, and not in a good way.

Jordan Ormond contributed to this story.

Suzanne Carlile, “Nurse Suzy,” has been a nurse since 1982. Her main focus is critical care and nursing education. She holds a master’s degree in nursing, is a certified emergency nurse and a member of NNSDO Intermountain West Chapter.