Pleural Disorders

COPD

Shortness of breath and pain are common symptoms of pleural disorders. The pleural membranes encase the lungs’ exterior and line the inside of the chest cavity. When there is a buildup of fluid, blood, or gas between the layers, there is a risk of lung collapse. Treating pleural disorders requires removing the substance between the pleural layers and treating the underlying cause of the pleural disorder.

Pleural disorders are marked by shortness of breath and discomfort or pain. However, there are several varieties of pleural disorders, with various causes and specific treatments.

The pleura are vital to the body’s respiratory and heart health. There are two layers of pleura, which is a large, thin tissue membrane encasing the outside of the lungs and lining the inside of the chest cavity. Typically, a small amount of fluid rests between the two pleural layers to help them glide smoothly past each other with each respiration. However, when pleural problems develop, the amount of fluid may increase markedly.

Pleural disorders sometimes result from viruses, while others are due to chronic conditions such as COPD or congestive heart failure. Still others stem from injuries. Diagnosing pleural disorders often includes chest x-rays, a chest CT, an ultrasound of the chest, or MRI. Blood tests also help in diagnosing the problem. In some cases, a biopsy is necessary. The treatment for all involves removing the built up substance from the pleural space, providing pain relief, and treating the underlying causes of the condition.

  • Pleurisy is an inflammation of the pleura. Pleurisy causes a sharp, stabbing pain when breathing, and increases with deeper breaths. It is usually caused by a viral infection. Other symptoms of pleurisy are shortness of breath, coughing, fever, and weight loss.1
  • Pleural effusion occurs when there is a buildup of excess fluid in the area between the two pleural membranes. In many cases, the cause of pleural effusion is congestive heart failure. Although people with the condition may have shortness of breath, there are often no symptoms at all.
  • Pneumothorax occurs in individuals with lung diseases such as tuberculosis and chronic obstructive pulmonary disease, or COPD. It refers to the accumulation of air or gas in the pleural space, and may appear in cases of acute lung injury. Some symptoms involve breathing, such as shortness of breath, tightness in the chest, and bluish skin tint. Additionally, many experience rapid heart rates, fatigue, and low blood pressure.
  • A hemothorax refers to a buildup of blood in the pleural space, and usually presents in cases involving chest injuries. Its symptoms include chest pain, shortness of breath, respiratory failure, anxiety, and a rapid heart rate.

Many cases of pleural disorders run the risk of lung collapse, warranting removal of the fluid, air, or blood from the pleural space. Most procedures involve a needle and/or plastic tube inserted into the pleural space. In cases where there is a great deal of fluid, a chest tube may be used. When thick pus and clotted blood appear in the pleural space, a chest tube delivers medicines into the pleural space to help drainage. Some cases also require surgery, when other less invasive methods fail.2

Additionally, treatment of any underlying conditions is required. During any fluid removal procedure, a sample of the substance is tested so that the correct medications are used to treat the cause of the pleural disorder, from antibiotics for a bacterial infection, to diuretics for cases involving heart failure.3

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Glossary

alveolus air sac where gas exchange takes place.
angina chest pain.
aorta blood vessel that delivers oxygen-rich blood from the left ventricle to the body; it is the largest blood vessel in the body.
apex top portion of the upper lobes of the lungs.
atrium one of the two receiving chambers of the heart.
base bottom portion of lower lobes, located just above the diaphragm.
blood pressure pressure of blood against the walls of a blood vessel or heart chamber.
bronchiolitis inflammation that involves the bronchioles (small airways).
bronchoscopy the examination of the bronchi (the main airways of the lungs) using a flexible tube (bronchoscope). Bronchoscopy helps to evaluate and diagnose lung problems, assess blockages, obtain samples of tissue and/or fluid, and/or to help remove a foreign body.
bronchus large airways; lung divides into right and left bronchi.
cardiac output total amount of blood being pumped by the heart over a particular period of time.
catheter thin, flexible medical tube; one use is to insert it into a blood vessel to measure blood pressure.
constrict tighten; narrow.
cyanosis bluish color in the skin because of insufficient oxygen.
diaphragm primary muscle used for respiration, located just below the lung bases.
diastolic pressure lowest pressure to which blood pressure falls between contractions of the ventricles.
dilate relax; expand.
dyspnea sensation of difficulty in breathing.
edema swelling due to the buildup of fluid.
endothelial cells the delicate lining, only one cell thick, of the organs of circulation.
expiration exhaling; giving off carbon dioxide.
heartbeat one complete contraction of the heart.
hyperactive describes a situation in which a body tissue is especially likely to have an exaggerated reaction to a particular situation.
hypertension abnormally high blood pressure.
hypotension abnormally low blood pressure.
inspiration inhaling; taking in oxygen.
lobectomy removal of an entire lobe of the lung.
lung volume the amount of air the lungs hold.
mean blood pressure average blood pressure, taking account of the rise and fall that occurs with each heartbeat. It is often estimated by multiplying the diastolic pressure by two, adding the systolic pressure, and then dividing this sum by three.
palpitation sensation of rapid heartbeats.
perfusion flow.
pleura membrane that covers the outside of the lung.
pneumonectomy removal of an entire lung.
pulmonary artery blood vessel delivering oxygen-poor blood from the right ventricle to the lungs.
pulmonary hypertension abnormally high blood pressure in the arteries of the lungs.
smooth muscle muscle that performs automatic tasks, such as constricting blood vessels.
spirogram record of the amounts of air being moved in and out of the lungs.
syncope fainting; temporary loss of consciousness.
systemic relating to a process that affects the body generally; in this instance, the way in which blood is supplied through the aorta to all body organs except the lungs.
systolic pressure the highest pressure to which blood pressure rises with the contraction of the ventricles.
vasodilator agent that widens blood vessels.
ventilation movement of air (gases) in and out of the lungs.
ventricle one of the two pumping chambers of the heart; right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery; left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta.