Читать книгу Respiratory Medicine - Stephen J. Bourke - Страница 48

Pain that is aggravated by inspiration or coughing is described as pleuritic pain, and the patient can often be seen to wince when breathing in, as the pain ‘catches’. Irritation of the pleura may result from inflammation (pleurisy), infection (pneumonia in adjacent lung), infarction of underlying lung (pulmonary embolism) or tumour (malignant pleural effusion). Chest wall pain resulting from injury to the intercostal muscles or fractured ribs, for example, is also aggravated by inspiration or coughing and is associated with tenderness at the point of injury. Whatever the cause of pleuritic pain, adequate analgesia is an essential component of treatment. If a patient is unable to take a deep breath or cough, pneumonia often follows.

Table 2.2 Major causes of haemoptysis