Pleurisy: What to Expect on Your Visit to a Pulmonologist
As with any disease, your doctor will first speak to you and asks for a detailed history. He or she will do a physical examination to come up with a differential diagnosis. Later, the diagnosis will be confirmed by doing some tests.
History Taking
Expect your pulmonologist to ask you questions regarding the symptoms you are having. Some of the things he/she may ask are:
- The time when you first develop the chest pain.
- Location in your body where it hurts the most.
- Asking if you are experiencing a gradual onset of pain or a sudden one.
- The type of pain you feel: a sharp pain or a dull pain
- If the pain radiates to other parts of the body, such as the arm, neck or shoulders.
- Other associated symptoms.
- The factors that aggravate the pain, such as breathing in and out, exercise, and other activities.
- The factors that can relieve the pain.
A chest pain is the most common symptom of a heart attack; therefore, your doctor will ask your further questions to exclude the possibility of a heart attack. Some of the questions he or she may ask you are:
- Does the pain radiate along the left arm or jaw?
- What were you doing at the time you developed the chest pain?
- Is the chest pain aggravated by walking or exercise?
- Is it a constricting type of chest pain?
- Do you have a family history of heart diseases?
- Are you a diabetic?
- Do you have hypertension or hyperlipidemia?
- Is this your first episode or have you had similar incidents in the past?
Physical Examination
After taking a detailed history from you, your doctor will do a complete physical examination to look for signs that may point toward pleurisy. He or she will listen to your lungs using a stethoscope to check if a pleural rub is heard. In pleurisy, the normal smooth pleura becomes rough due to the inflammation. When these inflamed pleura rub against each other with friction, they produce a rough scratching sound, which is known as the pleural rub. Your doctor will listen to your lungs and check if this sound is heard. If a friction rub is heard, pleurisy can be diagnosed, as it is a classic feature of pleurisy.
Other important physical signs that your doctor may look for are decreased breath sounds and reduced chest wall movements. Sometimes, a person presenting a pleuritic chest pain may have a normal physical examination, but further tests will have to be done to diagnose the condition.
After taking a full history and complete physical examination, your doctor will order further tests to confirm the diagnosis and to find the underlying cause of pleurisy. As pleuritic chest pain can be the presenting feature of pneumonia, pulmonary embolism, and pneumothorax, your doctor will order a chest X-ray to identify what the exact underlying cause is. Pleural effusions can also be identified using a chest X-ray.
