Cancer Lung Cancer Living With Causes of Pain With Deep Breathing Understanding Pleurisy (Pleuritic Chest Pain) By Lynne Eldridge, MD Lynne Eldridge, MD Facebook Lynne Eldrige, MD, is a lung cancer physician, patient advocate, and award-winning author of "Avoiding Cancer One Day at a Time." Learn about our editorial process Updated on February 25, 2022 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Sanja Jelic, MD Medically reviewed by Sanja Jelic, MD Sanja Jelic, MD, is board-certified in sleep medicine, critical care medicine, pulmonary disease, and internal medicine. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Symptoms Lung-Related Causes Heart-Related Causes Musculoskeletal Causes Other Causes Diagnosis Frequently Asked Questions Pain with breathing is always something to see a healthcare provider about. That's whether it comes with regular breathing or when taking a deep breath. Pain from taking a deep breath is called pleuritic chest pain or pleurisy. The names come from the membranes lining the lungs, called pleura. The term pleurisy is sometimes used to describe any sharp pain with a deep breath. But it can also be used to describe inflammation of the pleura. This article looks at pleurisy symptoms, the various possible causes of it, and how it's diagnosed. Brianna Gilmartin / Verywell Symptoms Pleuritic pain may be triggered by medical conditions or injuries involving the lungs, pleura, or nearby tissues or organs, including: Ligaments, muscles, and soft tissues of the chest The thoracic spine (between the neck and waist) The heart and pericardium (lining of the heart) The esophagus The breast Symptoms that accompany pleuritic chest pain often point to the underlying cause. They include: CoughingShortness of breathHoarsenessWheezingPain spreading the back or shoulderFever and/or chills Pleuritic pain may occur only with deep breaths. Or it may be present all the time but get worse when you take a deep breath. It tends to be sudden, sharp, stabbing, and intense. Lung-Related Causes The lungs don't have pain receptors. Still, medical conditions involving the lungs can cause pain in several ways. That includes irritation of the pleura. These conditions can be cancerous, infectious, or non-infectious. Cancer Cancerous causes of pleurisy include lung cancer, mesothelioma, and malignant pleural effusions. Lung Cancer The most common type of lung cancer is lung adenocarcinoma. It tends to grow around the edges of the lung near the pleura. It's most common in: People who've never smokedPeople assigned female at birthYoung adults The earliest symptom may be pain from cancer reaching the pleura. Mesothelioma Mesothelioma is a type of cancer that arises in the pleura. It's most common in people who've been exposed to asbestos. You can be exposed to asbestos at work or when remodeling homes built before asbestos was banned. Malignant Pleural Effusion Malignant pleural effusions cause fluid to build up in the pleura. The fluid contains cancer cells. Effusions can occur due to lung cancer, breast cancer, and cancers that spread to the lungs. Infectious Causes Infectious causes of pain with breathing include: Pneumonia: A bacterial, viral, or fungal lung infection. Viral infections: Coxsackie virus, respiratory syncytial virus (RSV), influenza (flu), COVID-19, adenovirus, cytomegalovirus (CMV), and the Epstein Barr virus (EBV). Tuberculosis (TB): A bacterial infection that's uncommon in the United States but very common worldwide. Non-Infectious Causes Non-infectious causes of breathing-related pain include: Pleural effusion: Accumulation of fluid between the layers of the pleura. Can be caused by lung disease, heart disease, and autoimmune disorders.Pneumothorax: Partial or total lung collapse. Can trigger severe chest pain and shortness of breath. This is a complication of emphysema and other lung diseases.Pulmonary embolism: Potentially life-threatening. A blood clot breaks off and travels to the lungs. Risk factors are recent surgery, heart disease, and deep vein thrombosis (DVT).Pulmonary infarction (lung infarction): Occurs when a section of lung tissue dies because its blood supply is cut off. Studies of pleuritic chest pain have suggested pulmonary embolism is the most common life-threatening cause. It's the source of the pain in between 5% and 21% of cases. Heart-Related Causes The heart lies near the lungs and the pleura. So heart conditions may cause pain with breathing. Some heart-related conditions that cause pleuritic chest pain include: Pericarditis: Inflammation of the membrane lining the heart (pericardium). Causes include infection, lung and breast cancer, kidney disease, and autoimmune diseases like lupus. Myocardial infarction (heart attack): Caused by blocked blood flow to a portion of the heart muscle. Aortic dissection: A medical emergency. A weak aorta (artery) allows blood to spill into its inner lining. It often causes severe, tearing pain in the chest and back. Pulmonary hypertension: High blood pressure in the pulmonary artery. Causes include heart disease, lung disease, connective tissue disorders, and some medications. Musculoskeletal Causes Conditions involving bony or soft tissue structures in the chest may cause pain associated with breathing. Some of these include: Rib fractures: Pain develops suddenly. It may worsen with deep breaths or coughing. Costochondritis: A rare condition caused by inflammation between the ribs and sternum (breastbone). Pain can resemble that of a heart attack. Other Causes Other common conditions that cause pain with breathing usually cause other symptoms, as well. These conditions include: Hemothorax: Accumulation of blood in the pleural space, usually due to an injury. Shingles (herpes zoster): Reactivation of the chickenpox virus. May cause pleuritic pain if it affects the chest. Pain is followed after a few days by a painful rash. Gastroesophageal reflux disease (GERD): Can cause severe acid reflux, heartburn, and sometimes a chronic cough with pleuritic pain. Diagnosis Depending on your symptoms, your healthcare provider may order several tests. These include imaging, bloodwork, and other tests. Imaging Imaging studies include: Chest X-ray: May show some problems but is often of limited use. Chest X-rays are negative in up to 25% of people with lung cancer.Computed tomography (CT): A type of X-ray using multiple images to create three-dimensional pictures.Magnetic resonance imaging (MRI): An imaging test that can show details of the body's soft tissue.CT lung angiography: Checks for pulmonary embolisms or arteriovenous malformations (abnormal veins) in the lungs.CT heart: Examines the structure of the heart.Echocardiogram: This is an ultrasound test of your heart that can visualize the heart while it's in motion.Bronchoscopy: During this test, a flexible tube is inserted through the mouth and threaded down into the large airways of the lungs (the bronchi).Thoracoscopy: A scope is inserted into the chest cavity to directly visualize the lung (usually to diagnose lung cancer). Bloodwork Blood tests your provider may order include: Erythrocyte sedimentation rate (ESR) C-reactive protein (CRP) These look for markers of inflammation. They can help identify autoimmune diseases and other inflammatory conditions. Other Tests You may also be sent for: Electrocardiogram (EKG): Used to check for heart rhythm abnormalities. Thoracentesis: A needle is used to extract fluid from the pleural cavity to diagnose (and treat) pleural effusion. Lung tissue biopsy: A tissue sample is taken and examined by a pathologist. Often used to diagnose cancer. Oximetry: A non-invasive test to measure blood oxygen levels. Pulmonary function tests: These measure lung capacity and performance. Treatments The treatment options for painful breathing depend on the specific cause. Early diagnosis is typically associated with greater treatment success. When to Call a Healthcare Provider If pain is severe or persists for more than a couple of daysWhen the symptoms develop suddenly and profoundlyWhen pain interferes with breathingIf you feel lightheaded, dizzy, or like you're going to faintIf you cough up any blood, however lightIf you have a high fever (over 100.4 degrees Fahrenheit) and/or chillsIf you have rapid or irregular heartbeats Summary Many things can cause pleurisy. That includes several lung conditions, heart conditions, infections, and musculoskeletal problems. Breathing-related pain can be diagnosed using a wide array of imaging studies, bloodwork, and other tests. You should always treat breathing-related problems as a medical emergency and get immediate help. A Word From Verywell Pain with breathing can be scary. You should always pay attention to this symptom and get medical attention. Most causes of pleurisy aren't life-threatening. But enough of them are to warrant a proactive approach. Getting an early diagnosis and treatment can mean a faster recovery. What Right-Sided Chest Pain Means Frequently Asked Questions Are chest pain and trouble breathing signs of COVID? Chest pain can be a symptom of COVID-19. Up to about 18% of people with it have some chest pain. These may be due to cardiac complications or infection of the pleura.Chest pain in COVID may or may not be accompanied by difficulty breathing. Get medical attention if you've tested positive for the coronavirus or suspect you’ve been exposed. Is it normal to have chest pain and trouble breathing when you work out? Chest pain and trouble breathing are not considered "normal." They may be signs of a serious condition like heart disease.That said, exercise-induced bronchospasm (EIB) is not always something to worry about. It causes your airways to narrow during physical exercise.You can avoid or manage episodes by adjusting your workout routine or treating underlying conditions such as allergies, which put you at risk for EIB. What is pleurisy? Pleurisy is an inflammation of the pleurae—the tissue that lines the lungs. The term pleurisy has been around since about 5 B.C. and has historically been used to describe pain upon taking a deep breath. Pleurisy is also known as pleuritic chest pain. Can pleurisy go away on its own? It depends. If a viral infection causes pleurisy (e.g., the flu), it most often resolves without treatment.If it's due to a bacterial infection, you may need an antibiotic. Fungal or parasitic causes may require medication, as well. Was this page helpful? Thanks for your feedback! Limiting processed foods and red meats can help ward off cancer risk. These recipes focus on antioxidant-rich foods to better protect you and your loved ones. Sign up and get your guide! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 6 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Reamy BV, Williams PM, Odom MR. Pleuritic chest pain: Sorting through the differential diagnosis. Am Fam Physician. 2017;96(5):306-312. Karkhanis VS, Joshi JM. Pleural effusion: diagnosis, treatment, and management. Open Access Emerg Med. 2012;4:31-52. doi:10.2147/OAEM.S29942 Khandaker MH, Espinosa RE, Nishimura RA, et al. Pericardial disease: diagnosis and management. Mayo Clin Proc. 2010;85(6):572-93. doi:10.4065/mcp.2010.0046 Tulay CM, Yaldiz S, Bilge A. Do we really know the duration of pain after rib fracture?. Kardiochir Torakochirurgia Pol. 2018;15(3):147-150. doi:10.5114/kitp.2018.78437 Patrini D, Panagiotopoulos N, Pararajasingham J, Gvinianidze L, Iqbal Y, Lawrence DR. Etiology and management of spontaneous haemothorax. J Thorac Dis. 2015;7(3):520-6. doi:10.3978/j.issn.2072-1439.2014.12.50 Weng L-M, Su X, Wang X-Q. Pain symptoms in patients with coronavirus disease (COVID-19): a literature review. JPR. 2021;Volume 14:147-159. doi:10.2147/JPR.S269206 Additional Reading Berchuck J, Patel, S. An often-overlooked etiology of pleuritic chest pain. Journal of General Internal Medicine. 2016. 31(1):138. doi:10.1007/s11606-015-3316-4 Hogg K, Dawson D, Mackway-Jones, K. Outpatient diagnosis of pulmonary embolism: the MIOPED (Manchester Investigation Of Pulmonary Embolism Diagnosis) study. Emerg Med J. 2006;23(2):123-27. DOI: 10.1136/emj.2005.027110. Jany, B. Pulmonary causes of chest pain. Internist. 2017. 58(1):22-28. doi:10.1007/s00108-016-0169-9 Reamy BV, Williams PM, Odom MR. Pleuritic chest pain: Sorting through the differential diagnosis. Am Fam Physician. 2017;96(5):306-312. Yan G, Littlewood A, Latimer, M. Unusual cause of pleuritic chest pain in a child. BMJ Case Reports. 2016. pii: bcr2016217307. doi:10.1136/bcr-2016-217307