Pleuritis
Background
- Pleuritis (also known as pleurisy) is nonspecific inflammation of the parietal pleura[1]
- Most often follows a viral illness
Clinical Features
- Pleuritic chest pain
- Typically sharp in nature, worse with respiration, coughing, sneezing, etc
- May complain of shortness of breath as a result of pain
Differential Diagnosis
Chest pain
Critical
- Acute coronary syndromes (ACS)
- Aortic dissection
- Cardiac tamponade
- Coronary artery dissection
- Esophageal perforation (Boerhhaave's syndrome)
- Pulmonary embolism
- Tension pneumothorax
Emergent
- Cholecystitis
- Cocaine-associated chest pain
- Mediastinitis
- Myocardial rupture
- Myocarditis
- Pancreatitis
- Pericarditis
- Pneumothorax
Nonemergent
- Aortic stenosis
- Arthritis
- Asthma exacerbation
- Biliary colic
- Costochondritis
- Esophageal spasm
- Gastroesophageal reflux disease
- Herpes zoster / Postherpetic Neuralgia
- Hypertrophic cardiomyopathy
- Hyperventilation
- Mitral valve prolapse
- Panic attack
- Peptic ulcer disease
- Pleuritis
- Pneumomediastinum
- Pneumonia
- Rib fracture
- Stable angina
- Thoracic outlet syndrome
- Valvular heart disease
- Muscle sprain
- Psychologic / Somatic Chest Pain
- Spinal Root Compression
- Tumor
Evaluation
Workup
Pleuritis is a diagnosis of exclusion
Diagnosis
- Typically made clinically after ruling out emergent causes of chest pain
Management
- NSAIDs
- Indomethacin is recommended agent (most studied)
Disposition
- Discharge
See Also
External Links
References
- ↑ Kass SM, Williams PM, Reamy BV. Pleurisy. Am Fam Physician. 2007;75(9):1357-1364.