Deep breathing pain: symptoms, causes and diagnosis

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If you feel pain when you breathe, whether it's breathing normally or taking deep breaths, you are probably concerned. Health professionals describe pain that occurs with deep breaths as pleurisy or pleurisy . The name comes from the membranes that line the lungs known as the pleura .

The term pleurisy is sometimes used to describe any sharp pain that occurs with deep breathing, but it can also be used to describe inflammation of the pleura. Pleurisy pain can be caused by a number of disorders, diseases, or injuries that affect the lungs, pleura, or related tissues or organs, including:

  • Ligaments, muscles and soft tissues of the chest.
  • Thoracic spine
  • Heart and pericardium (inner lining of the heart)
  • Esophagus
  • Breast

Brianna Gilmartin / Get Medication Information

Symptoms

There are a number of symptoms that can occur along with painful breathing, depending on the underlying cause, including:

  • Cough
  • Difficulty breathing
  • Hoarseness
  • Wheezing
  • The pain spreads down the back or shoulder.
  • Fever and / or chills

Pleurisy pain can occur with breathing alone or be generalized, but intensify with inhalation. Pleurisy pain is sudden, sharp, stabbing, and severe.

Causes associated with the lungs.

Although the lungs themselves do not have pain receptors, medical conditions associated with the lungs can cause pain in a number of ways, including irritating the pleura. Some of these include:

  • Pneumonia is a lung infection that can be bacterial, viral, or fungal.
  • Viral infections can often cause pleurisy pain. These include Coxsackie virus, respiratory syncytial virus (RSV), influenza, parainfluenza, novel coronavirus (COVID-19), mumps, adenovirus, cytomegalovirus (CMV), and Epstein-Barr virus. (EBV).
  • Lung cancer is often accompanied by pleuritic pain. The most common type, adenocarcinoma of the lung , tends to grow on the periphery of the lung near the pleura and is most common in people who have never smoked, women, and young people with lung cancer. Sometimes these cancers cause symptoms first when they spread to the pleura and cause pain.
  • Pleural effusion is the accumulation of fluid between the layers of the pleura that can be caused by a number of conditions, including lung diseases, heart disease, and autoimmune disorders (such as rheumatoid arthritis). Malignant pleural effusions are pleural effusions that contain cancer cells associated with lung cancer, breast cancer, and metastatic cancer that has spread to the lungs.
  • A pneumothorax is a collapse of part or all of the lung that can cause severe chest pain and shortness of breath. Pneumothorax is a common complication of emphysema and other lung diseases.
  • Pulmonary embolism is a life-threatening condition in which a clot in a vein breaks off and travels to the lungs. Risk factors for pulmonary embolism include recent surgery, heart disease, and deep vein thrombosis (DVT).
  • Lung infarction Also called a pulmonary infarction, it occurs when part of the lung tissue dies because its blood supply is blocked.
  • Mesothelioma is a type of cancer that occurs in the pleura and is more common in people who have been exposed to asbestos . Exposure to asbestos can occur on the job or in people who are remodeling houses built before asbestos was banned for this use.
  • Tuberculosis (TB) is a relatively rare cause of pleuritic pain in the United States, but a very common cause throughout the world. However, it appears that tuberculosis is on the rise in the United States, and anyone who has traveled should be screened if they are managing lung pain .

Studies of pleuritic chest pain have shown that pulmonary embolism is the most common life-threatening cause and a source of pain in 5% to 21% of cases.

Causes of the heart

Because the heart is close to the lungs (and pleura) and moves when you breathe, heart disease can cause pain when you breathe. Some heart conditions that cause chest pain from pleurisy include:

  • Pericarditis is inflammation of the membranes that line the heart (pericardium). Pericarditis has many causes, including infections, cancer (most commonly lung and breast cancer), autoimmune conditions such as lupus, and kidney disease.
  • Myocardial infarction (heart attack) is caused by a blockage of blood flow to part of the heart muscle.
  • Aortic dissection is a medical emergency in which the weakening of the aorta allows blood to spill over the lining of the aorta. This often causes severe tearing pain that can be felt in the chest and back.
  • Pulmonary hypertension is a serious condition in which the blood pressure in the pulmonary artery increases. Pulmonary hypertension can be caused by a number of conditions, including heart disease, lung disease, connective tissue disease, and even certain medications.

Musculoskeletal causes

Conditions that affect any of the bony or soft tissue structures of the chest can cause pain that occurs or worsens with breathing. Some of these include:

  • Rib fractures often cause pain that develops gradually and worsens with deep breathing and coughing .
  • Costochondritis is an inflammation of the junction of the ribs, often with pain when breathing and swelling around the breastbone. Costochondritis is often mistaken for a heart attack.

Other possible causes

There are also reasons that may not initially be obvious.

  • Hemothorax is a collection of blood in the pleural space, usually as a result of injury .
  • Shingles (shingles) is a reactivation of the varicella-zoster virus that can cause pleurisy pain if it occurs in one of the dermatomes (nerve groups) in the chest. Shingles is more common in older adults, and the risk increases with age. Although shingles is usually associated with a rash, pain often precedes the rash by several days, sometimes making initial diagnosis difficult.
  • Gastroesophageal reflux disease (GERD) can cause severe acid reflux and cause symptoms, often in the middle of the night, that are mistaken for a heart attack. Sometimes there is pain when breathing. GERD can also cause a chronic cough and other symptoms that are easily attributed to the lungs.

Diagnostics

Your doctor may recommend several different tests based on your symptoms. These include :

  • Chest X-ray: A chest X-ray can be helpful if it shows a problem, but a negative X-ray cannot rule out many of the possible causes of pleuritic chest pain. For example, a chest X-ray is negative in 25% of people with lung cancer.
  • Computed Tomography (CT): This is a type of X-ray in which multiple images create "slices" of internal organs or parts of the body.
  • Magnetic Resonance Imaging (MRI): Magnetic resonance imaging is best at visualizing soft tissues.
  • CT angiography – Used to detect heart disease.
  • Electrocardiogram (ECG) – Used to check for abnormal heart rhythms.
  • Echocardiogram – This is an ultrasound of your heart.
  • Thoracentesis: This procedure is used to remove fluid from the pleural space with a needle and syringe.
  • Bronchoscopy: In this test, a flexible tube is inserted through the mouth and pushed into the large airways of the lungs (bronchi).
  • Thoracoscopy: A telescope is inserted into the chest cavity for direct visualization of the lungs (usually to diagnose lung cancer).
  • Lung biopsy – A pathologist takes a tissue sample and examines it.
  • Oximetry: measures the level of oxygen in the blood.
  • Blood tests: These include erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), both of which detect generalized inflammation.
  • Pulmonary function tests : measure the capacity and performance of the lungs.
  • D-dimer test : used to detect blood clots (pulmonary embolism).

Watch out

Treatment options for painful breathing will depend on the specific cause. The outcome of treatment depends on the severity of the underlying disease. As with any disease, early diagnosis is usually associated with greater treatment success.

Frequently asked questions

Are chest pain and shortness of breath a sign of COVID?

Chest pain can be a symptom of COVID-19, and between 1.6% and 17.7% of patients experience it to some degree. It may or may not be accompanied by shortness of breath. While it is not clear whether the chest pain is the result of heart complications or a pleural infection, it is considered a sign of severe COVID-19. If you test positive for coronavirus or suspect you've been infected, discuss your symptoms with your doctor.

When you exercise, is it normal to have chest pain and shortness of breath?

Chest pain and shortness of breath are not considered "normal" and can be a sign of a serious condition, such as heart disease. However , exercise-induced bronchospasm is not always a cause for concern. In this condition, the airways in the lungs narrow during exercise. About 5% of people have IBD, but it is much more common in serious athletes. You are taking steps to prevent or control episodes by changing your exercise routine or treating underlying medical conditions, such as allergies , that put you at risk for these bronchospasms.

Can pleurisy go away on its own?

If pleurisy is caused by a viral infection such as the flu , it often goes away and goes away on its own without any treatment. However, you may need a pain reliever or other medication to help you manage your chest pain and associated symptoms. In cases where pleurisy is the result of a bacterial infection, your doctor will usually prescribe an antibiotic. Antifungal or antiparasitic medications may be needed to treat other forms of pleurisy.

Get the word of drug information

Pleurisy pain can mean something serious or relatively mild and easy to treat. Therefore, it is important that you do not ignore the pain or mask it with pain relievers. After all, respiratory pain can never be considered normal or easily ignored.

When to call your healthcare provider

  • If the pain is severe or does not go away for more than a couple of days.
  • When symptoms develop suddenly and profoundly
  • When pain gets in the way
  • If you feel dizzy, dizzy, or weak
  • If you cough up blood, no matter how lightly
  • If you have a high fever (over 100.4 F) and / or chills
  • If you experience a fast or irregular heartbeat.
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