Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Could Breathlessness And Shallow Breathing Be Signs Of Pleurisy?
Question: 38 year old Male here. for the past 3 days I've been short of breath to the point that my blood oxygen level falls quickly to 92% or so when I'm not purposefully deep breathing. it feels like I'm holding my breath, but I don't think i am. 5 days ago I had the chills all day and felt like I had a sunburn all over my back, but didn't have a sunburn. 4 days ago I had a lot of nasal congestion and dry cough. the nasal issue has largely resolved and the cough is only a few times a day of now, but the shortness of breath continues. my subconscious breathing is now very shallow and mostly chest breathing. it hurts/burns mildly to lean forward and to lay on either side. so far the most comfortable I've been is almost fully sitting up. also, when I walk, my heartrate goes up to like 130. I went to the ER and they said my ekg was fine, my heart is not enlarged and diagnosed me with Pleurisy. i do not see anything in the radiology report that suggests pleurisy. please see attached notes...do you? do you agree with the diagnosis? what else could it be? I had a angiogram and stress test 2 years ago that came back as normal.
Brief Answer:
Likely a pleuritic chest pain only
Detailed Answer:
Hello,
Its unlikely to be a cardiac issue. Its likely a pleuritic chest pain only. This will not be visible on chest scan.
Also, considering this is preceded by a viral prodrome of cough, rhinitis etc, very much favor pleurisy. Its a typical presentation of pleurisy which you are having. Also, it'd unlikely for cardiac pain to increase on one or other side. You are also young to have heart attack. So overall, it's unlikely to be heart attack. This is likely to persist for a week.
Now, your shortness of breath could be due to pain only. As you are having pleuritic pain, which increases on inspiration, your body reflexly tend to withhold the breath leading to shortness of breath. Also, another possibility for shortness of breath is bronchoconstriction which may be associated with such infection, especially if you are having wheezing as well. You should have NSAIDS like Advil or Naproxen for pain relief and if it's persists even after pain relief then you should have bronchodilators like albuterol 2 puff sos upto 4-6 times a day.
Hope this helps you and get back if you have any doubts.
Likely a pleuritic chest pain only
Detailed Answer:
Hello,
Its unlikely to be a cardiac issue. Its likely a pleuritic chest pain only. This will not be visible on chest scan.
Also, considering this is preceded by a viral prodrome of cough, rhinitis etc, very much favor pleurisy. Its a typical presentation of pleurisy which you are having. Also, it'd unlikely for cardiac pain to increase on one or other side. You are also young to have heart attack. So overall, it's unlikely to be heart attack. This is likely to persist for a week.
Now, your shortness of breath could be due to pain only. As you are having pleuritic pain, which increases on inspiration, your body reflexly tend to withhold the breath leading to shortness of breath. Also, another possibility for shortness of breath is bronchoconstriction which may be associated with such infection, especially if you are having wheezing as well. You should have NSAIDS like Advil or Naproxen for pain relief and if it's persists even after pain relief then you should have bronchodilators like albuterol 2 puff sos upto 4-6 times a day.
Hope this helps you and get back if you have any doubts.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
thanks! no pain unless I constrict my chest by laying in the fetal position or really lean forward or lay on either side. no pain then exhaling or inhaling. do you still think its pleurisy given I dont have pain?
Brief Answer:
Still can be a pleurisy but not that strongly
Detailed Answer:
Ok..so if you don't have typical pleuritic pain, then also it can be a pleurisy but we have to think of other possibilities as well. But, it's unlikely to be of cardiac cause as cardiac pain will not increase in this manner at all. So I think, cardiac possibility is out. Another possibility of musculoskeletal type of pain, which can accompany a viral infections. Considering pain occurs whenever there is a kind of pressure over the chest area, musculoskeletal pain becomes a likely possibility. So I think, you should have NSAIDS for it and make yourself comfortable.
This will not explain shortness of breath, unless it's it's becoming uncomfortable for you to breath due to chest pain or heaviness. I guess you must have been auscultated by doctor, was he mentioned anything regarding wheezing or rhonchi. Do you hear audible wheeze or whistle like sound while breathing, if yes you should try using inhalers for response. You should also try steam inhalation if available at home to ease breathing. If shortness of breath is severe then it's better to visit er again, as nothing is clear cut till now, and your investigations didn't show anything.
Next possibility if of anxiety. This may cause all your symptoms, if you are too much anxious or getting panic.
Still can be a pleurisy but not that strongly
Detailed Answer:
Ok..so if you don't have typical pleuritic pain, then also it can be a pleurisy but we have to think of other possibilities as well. But, it's unlikely to be of cardiac cause as cardiac pain will not increase in this manner at all. So I think, cardiac possibility is out. Another possibility of musculoskeletal type of pain, which can accompany a viral infections. Considering pain occurs whenever there is a kind of pressure over the chest area, musculoskeletal pain becomes a likely possibility. So I think, you should have NSAIDS for it and make yourself comfortable.
This will not explain shortness of breath, unless it's it's becoming uncomfortable for you to breath due to chest pain or heaviness. I guess you must have been auscultated by doctor, was he mentioned anything regarding wheezing or rhonchi. Do you hear audible wheeze or whistle like sound while breathing, if yes you should try using inhalers for response. You should also try steam inhalation if available at home to ease breathing. If shortness of breath is severe then it's better to visit er again, as nothing is clear cut till now, and your investigations didn't show anything.
Next possibility if of anxiety. This may cause all your symptoms, if you are too much anxious or getting panic.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
no wheezing. the pain unrelated to lying certain ways only seems to occur when my blood oxygen level drops to below 95%. it feels like the pain is coming from the center of my chest but deeper than my chest muscles. when its above 95% I just feel the shortness of breath unless I lay on my side.
---------------------+++++++++++++++++++++
warm steam ok?
---------------------+++++++++++++++++++++
warm steam ok?
Brief Answer:
One more possibility is of gastritis and reflux disease
Detailed Answer:
Okay..
Its highly unusual for any disease to have pain only when saturation drops below 95 percent. However, vice versa is possible, pain may restrict respiration leading to saturation drop.
Another possibility of pain in your setting is of gastritis and reflux disease. This is usually associated with upper abdominal pain increases on meals, increase in pain on lying down, associated nausea etc.
How much is your resting respiratory rate, pulse rate, is there a history of similar illness in the past, is excessive stress or anxiety associated?
I think it's worthwhile to try steam inhalation and inhalers especially if you are having severe shortness of breath even if audible wheeze is not present. Because, pleurisy, bronchoconstriction, reflux disease are the conditions which can't be seen on ct scan.
Also, repeat examination by doctor will be helpful in making diagnosis, so should be perceived once.
-----------------------+++++++++++++++++++++++
Brief Answer:
Yes, warm steam is ok
Detailed Answer:
Yes, warm steam is fine. You also have antacids like Pantoprazole 40 mg before breakfast once a day, or other like lansoprazole, omeprazole, whichever is available. Today's dose, you have now only.
One more possibility is of gastritis and reflux disease
Detailed Answer:
Okay..
Its highly unusual for any disease to have pain only when saturation drops below 95 percent. However, vice versa is possible, pain may restrict respiration leading to saturation drop.
Another possibility of pain in your setting is of gastritis and reflux disease. This is usually associated with upper abdominal pain increases on meals, increase in pain on lying down, associated nausea etc.
How much is your resting respiratory rate, pulse rate, is there a history of similar illness in the past, is excessive stress or anxiety associated?
I think it's worthwhile to try steam inhalation and inhalers especially if you are having severe shortness of breath even if audible wheeze is not present. Because, pleurisy, bronchoconstriction, reflux disease are the conditions which can't be seen on ct scan.
Also, repeat examination by doctor will be helpful in making diagnosis, so should be perceived once.
-----------------------+++++++++++++++++++++++
Brief Answer:
Yes, warm steam is ok
Detailed Answer:
Yes, warm steam is fine. You also have antacids like Pantoprazole 40 mg before breakfast once a day, or other like lansoprazole, omeprazole, whichever is available. Today's dose, you have now only.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
