pleuritic chest pain

Pleuritic chest pain is a sharp, stabbing pain in the chest that gets distinctly worse with breathing in, coughing, laughing or moving. Sufferers often hold their breath or breathe shallowly to avoid it and can point with one finger to where it hurts.

The pain comes from the pleura, the two thin membranes that line the lung surface and the inside of the chest wall. Normally these glide silently over each other on a film of fluid. When the outer membrane becomes inflamed or irritated, the two surfaces rub or its pain nerves fire with each movement, producing pain tightly locked to the breathing cycle. The lung surface itself has no such pain sensation; the pain is generated by the chest-wall side of the pleura.

Many conditions inflame or irritate the pleura: viral infection, pneumonia reaching the lung surface, pulmonary embolism, pneumothorax, and inflammatory diseases such as lupus. Because some of these are serious, sharp breathing-linked chest pain — especially with breathlessness, a fast heart rate or risk factors for clots — is taken seriously rather than dismissed as muscular.