Condition: Pleural Disease

The chest cavity contains the heart, the thoracic aorta, lungs and esophagus (swallowing passage). The wall of the chest cavity is made up of the rib cage and diaphragm. The pleura is a large membrane that lines the thoracic (chest) cavity and covers the lungs. The pleura produces lubricant for the lungs so they are able to move back and forth against the chest wall when you breathe.

What are Pleural Diseases?

There are a variety of conditions that emerge out of problems with the pleura. As detailed below, the causes of your disease will depend on what kind of pleural diastase you have. Broadly, the symptoms of pleural diseases are:

• A cough
• Shortness of breath
• Fever and chills
• Unexplained weight loss
• Rapid, shallow breathing

Causes of different types of Pleural Disease

•  Hemothorax is an accumulation of blood in the pleural cavity.
• Most cases are caused by chest trauma, but may also be causes by lung/pleural cancer and chest/heart surgery.
• Symptoms of a Hemothorax include chest pain, shortness of breath, anxiety/restlessness, increased heart rate, respiratory failure if large.
• Pleural effusion is one of the most common problems associated with the pleura. It is an accumulation of excess fluid in the pleural cavity which then pushes against the lung. This then prevents full expansion of the lungs when you try to breathe.
• Pleural effusion can be caused by: congestive heart failure, lung cancer, pneumonia, tuberculosis, liver disease, pulmonary embolism, lupus or adverse reaction to specific medications
• Pleural effusion can be aymptomatic  or otherwise may produce shortness of breath and cough.
• Empyema is the accumulation of pus in the pleural cavity. This is a type of pleural effusion that is usually associated with pneumonia
• The symptoms are those of the pneumonia (cough, fever) in addition to shortness of breath and impaired breathing.
• Pleural tumors are malignant tumors arising from the pleura (e.g. mesothelioma). They may also spread to the pleura (metastatic) from another site, and benign tumors arising from the pleura.
• Symptoms include Shortness of breath, chest pain, cough, unexpected weight loss
• Pleurisy is inflammation of the pleura,
• Pleurisy is usually caused by an infection in the respiratory system by a virus or bacteria. Other causes include: leak of air into pleural cavity from a punctured lung, chest injury, tuberculosis or other infection, tumor in the pleural cavity, rheumatoid arthritis, lupus, sickle cell crisis, pulmonary embolism, pancreatitis, complications from heart surgery
• Symptoms pleurisy include: chest pain on taking a deep breath, shortness of breath, fever and/or chills, joint swelling and/or soreness, unexpected weight loss
• Pneumothorax is an accumulation of air within the pleural cavity between the outside of the lung and the inside of the rib cage.
• Pneumothorax is usually caused by injury to the lung causing a leak of air, chronic obstructive pulmonary disease or other lung disease, tuberculosis, ruptured air blisters (blebs), mechanical ventilation
• Symptoms can include: sudden sharp pain that worsens with deep breathing, shortness of breath, chest tightness, fatigue, fast heart rate, bluish skin color (called

In order to diagnose your condition, your doctor will ask you for a medical history and will then consider findings from any physical examination. If you doctor suspects you have a pleural disease, they will order you a chest x-ray, which shows the interior of the chest cavity, and a CT scan. You may be asked to swallow some dye to ensure that the blood vessels and organs show up clearly in these scans.

The treatment you receive for Pleural Disease will be based on the kind of condition that you have. Some of treatments may include:

• The placement of a chest tube to evacuate air
• Draining fluid with a needle (thoracentesis) or a chest tube
• Opening the chest to remove the diseased pleura (decortication).
• Abrading the pleural surface to achieve adherence of the lung to the chest wall may be required for recurrent pneumothorax.
• In some cases of malignancy (mesothelioma), removal of all of the pleura as well as the underlying lung (extrapleural pnemonectomy) may be indicated.

Your doctor at OneWelbeck will discuss with you the diagnosis and surgical and non-surgical options for treatment and design you a treatment plan that is right for you.