ABSTRACT
This chapter discusses 'pleuritic chest pain' that will be used to refer to any chest pain that is sharp, well localised and exacerbated by inspiration, regardless of its origin. Pain in general may be divided into three categories, namely somatic, visceral and neuropathic. Somatic pain arises from superficial structures such as the skin, ribs and intercostal muscles, as well as the parietal pleura and pericardium. Pleuritic chest pain refers to pain arising from pleural irritation. It is characterically sharp in nature, well localised and exacerbated by inspiration, and is thus a form of somatic pain, mediated by fast-conducting A-delta fibres. Since pain with very similar characteristics may result from pathology affecting the chest wall or pericardium, these conditions are best discussed together. Potentially life-threatening causes of pleuritic chest pain include pulmonary embolism, tension pneumothorax, pneumonia and empyema. Tension pneumothorax is an immediately life-threatening cause of pleuritic chest pain.
