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By Mayo Clinic staffA double layer of membranes called pleura separate your lungs from your chest wall. One layer of the pleura overlies each lung. The other layer lines the inner chest wall. The layers are like two pieces of smooth satin rubbing against each other with almost no friction, allowing your lungs to expand and contract when you breathe without any resistance from the lining of the chest wall.
When inflamed, the two layers of the pleural membrane in the affected side of your chest rub against each other like two pieces of sandpaper, producing the pain of pleurisy when you inhale and exhale.
The underlying medical conditions that can cause pleurisy are numerous. Pleurisy causes include:
- An acute viral infection, such as the flu (influenza)
- Pneumonia, in those cases in which the infected portion of your lung involves the surface of the pleura
- Autoimmune conditions, such as lupus, rheumatoid arthritis and autoimmune hepatitis
- Tuberculosis and other infections
- A clot in an artery of your lungs (pulmonary embolism)
Pleurisy can also occur as a result of trauma to your chest or after heart surgery. Rib fractures also may cause pleurisy. It's possible to fracture a rib in the absence of trauma, such as from a severe cough. In some cases, the cause of pleurisy is unknown (idiopathic).
Cancer in the lung rarely causes pleurisy. There's no relationship between smoking and pleurisy, but a "smoker's cough" will aggravate the pain of this condition.
- What are pleurisy and other disorders of the pleura? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/pleurisy/pleurisy_whatare.html. Accessed Dec. 15, 2008.
- Pleurisy fact sheet. American Lung Association. http://www.lungusa.org/site/apps/nlnet/content3.aspx?c=dvLUK9O0E&b=2060321&content_id=%7B653829A9-6104-4561-BFC5-528F5419BEC2%7D¬oc=1. Accessed Dec. 15, 2008.
- Kass SM, et al. Pleurisy. American Family Physician. 2007;75:1357.
- Pleural effusion. The Merck Manuals Online Medical Library: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec05/ch060/ch060d.html#sec05-ch060-ch060d-1244. Accessed Dec. 15, 2008.
- Celli BR. Diseases of the diaphragm, chest wall, pleura and the mediastinum. In: Goldman L, et al., eds. Goldman: Cecil Medicine. 23rd ed. Philadelphia, Pa.: Saunders Elsevier; 2007:697.
- Chest pain, acute. American Academy of Family Physicians. http://familydoctor.org/online/famdocen/home/tools/symptom/523.html. Accessed Dec. 15, 2008.
- Rosenow EC (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 23, 2008.