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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Diagnosed With Pleurisy, Chest Pains, No Clot In Lungs. Suggestions?

I have had chest pains for over 5 weeks now. The doctor said I had pleurisy . Been on two courses of antibiotics and had painkillers. Went to the hospital to rule out a blood clot in my lung . Had two X-rays which the doctor said were clear . Still in pain, doesn t seem to be getting better. The doctors havent given me anything else to help. Is there anything I can do?
Mon, 29 Oct 2012
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General & Family Physician 's  Response
Pleurisy is an inflammation of the pleura , the lining of the pleural cavity surrounding the lungs . Among other things, infections are the most common cause of pleurisy. The inflamed pleural layers rub against each other every time the lungs expand to breathe in air. This can cause severe sharp pain with inhalation.Since your symptoms are not subsiding may be the lesion is persisting which sometimes missed through x-ray.I advice thoracoscopy which is gold standard investigation.wishing you a good health.
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Pulmonologist Dr. Shashi Dangwal's  Response
You have already had two coures of antibiotics and your chest x rays are coming normal, hence any major illness seems to be unlikely. i suggest you get a CT chest done in case if there is anything that a x ray chest is unable to pick up. If that also comes normal, i suggest you take some pain killer, a local pain killer gel and proper rest. You should be alright soon.
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Pulmonologist Dr. Arnab Maji's  Response
Hi
Thanks for your query
First of all it is needed to look whether it is really a pleuritic pain or some else specially of heart origin.
Secondly, if it is due to pleurisy then need to find out its etiology.
Pleurisy mostly occurs due to lung infection specially pneumonia and tubercular pleuritis in our country. Malignancy rarely may cause pleurisy.
Another entity currently increasing on incidence i.e. connective tissue disorder specially SLE causes pleurisy.
Your doctor needs to exclude all these possibilities by serial investigations and also serial chest x-ray needs to be done to look for development of pleural effusion. If develops then our job will be much easier because pl fluid aspiration can make the diagnosis for you then.
ECG should also be done to exclude the heart causes.
Thank you.
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Diagnosed With Pleurisy, Chest Pains, No Clot In Lungs. Suggestions?

Pleurisy is an inflammation of the pleura , the lining of the pleural cavity surrounding the lungs . Among other things, infections are the most common cause of pleurisy. The inflamed pleural layers rub against each other every time the lungs expand to breathe in air. This can cause severe sharp pain with inhalation.Since your symptoms are not subsiding may be the lesion is persisting which sometimes missed through x-ray.I advice thoracoscopy which is gold standard investigation.wishing you a good health.