pleuritic chest pain
Summary
Pleuritic chest pain is sharp, stabbing chest pain that worsens with inspiration, coughing, or movement due to inflammation of the pleural membranes. It is a key symptom that helps differentiate pulmonary causes from cardiac causes of chest pain.
Detail
Pleuritic chest pain results from inflammation or irritation of the parietal pleura, which is innervated by intercostal nerves and the phrenic nerve, making it sensitive to pain (unlike the visceral pleura). The pain is characteristically sharp, knife-like, and localized, worsening with deep inspiration, coughing, sneezing, or thoracic movement because these actions stretch the inflamed pleural surfaces. Common causes include pneumonia, pulmonary embolism, pneumothorax, pleural effusion, pleuritis, and chest trauma. The presence of pleuritic pain suggests involvement of the pleural space and helps narrow the differential diagnosis. It contrasts with cardiac chest pain, which is typically described as pressure-like, substernal, and not affected by breathing. Physical examination may reveal a pleural friction rub in cases of dry pleuritis. Diagnostic workup often includes chest X-ray, CT scan, and sometimes thoracentesis depending on the suspected etiology.
Sources
- Harrison's Principles of Internal Medicine
- Murray & Nadel's Textbook of Respiratory Medicine
- First Aid for the USMLE Step 1
- UpToDate: Pleuritic chest pain in adults
Reviewed by AnkiBoss editorial — medical student review. Information here is for study reference only and is not medical advice. Spotted an error? Let us know.