Pleurodynia Clinical Presentation

Updated: Dec 08, 2020
  • Author: Irina Petrache, MD; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Presentation

History and Physical Examination

Pleurodynia should be considered in all cases of acute and subacute chest pain that present in the ER or in internal medicine, cardiology, or cardiothoracic surgery outpatient clinics. The onset of chest pain is acute. During attacks, the pain is severe, intense, and excruciating, lasting seconds to a minute. Pain is paroxysmal, occurring in attacks separated by minutes to hours. Severe attacks can result in difficulty breathing. The thoracic pain is usually over the lower ribs and is unilateral, but it can also occur over the front, back, or substernal area. Between attacks, patients usually have a constant, dull, pleuritic chest pain. A very important quality of the pain is its direct relationship to sneezing, coughing, laughing and deep breathing, which can cause the patient to look tachypneic and even diaphoretic. [12] The pain typically lasts 1 to 4 days, although pain lasting as long as 45 days has been reported. [2]

Patients can present with a wide range of signs and symptoms including the following [12] :

  • Upper respiratory tract symptoms, including sore throat (85%)
  • Acute and subacute chest pain
  • Constitutional symptoms, including headaches (50%), fever (97%), and malaise
  • Gastrointestinal symptoms, including nausea, vomiting, diarrhea (50%); abdominal pain (usually in the epigastric area) in children
  • Testicular pain (ie, orchitis) in 10% of males
  • Dermatitis (25%) and otitis (25%)