Dr. Schiffman received his B.S. degree with High Honors in biology from Hobart College in 1976. He then moved to Chicago where he studied biochemistry at the University of Illinois, Chicago Circle. He attended Rush Medical College where he received his M.D. degree in 1982 and was elected to the Alpha Omega Alpha Medical Honor Society. He completed his Internal Medicine internship and residency at the University of California, Irvine.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Pleurisy describes the chest pain syndrome characterized by a sharp
chest
pain that worsens with breathing.
Pleurisy is caused by inflammation of the linings around the lungs
(the pleura), a condition also known as pleuritis. There
are two layers of pleura: one covering the lung (termed the visceral pleura) and
the other covering the inner wall of the chest (the parietal pleura).
These two layers are lubricated by pleural fluid.
Pleurisy is frequently associated with the accumulation
of extra fluid in the space between the two layers of pleura. This fluid is
referred to as a pleural effusion.
The pain fibers of the lung are located in the pleura.
When this tissue becomes inflamed, it results in a sharp pain in the chest that
is worse with breathing. Other symptoms of pleurisy can include
cough, chest tenderness, and
shortness of breath.
What causes pleurisy?
Pleurisy can be caused by any of the following conditions:
Infections: bacterial
(including those that cause tuberculosis),
fungi, parasites, or
viruses
Inhaled chemicals or toxic substances: exposure to some cleaning agents like ammonia
Pulmonary embolism: blood
clot inside the blood vessels to the lungs. These clots sometimes severely
reduce blood and oxygen to portions of
the lung and can result in death to that portion of lung tissue (termed lung infarction). This, too, can cause
pleurisy.
Obstruction of lymph
channels: as a result of centrally located lung tumors
Trauma: rib fractures or
irritation from chest tubes used to drain air or fluid from the pleural cavity
in the chest
Certain drugs: drugs that
can cause lupus-like syndromes (such as
hydralazine [Apresoline], Procan [Pronestyl, Procan-SR, Procanbid
- these brands no longer are available in the U.S.], phenytoin [Dilantin],
and
others)
Abdominal processes: such
as pancreatitis,
cirrhosis of the liver,
gallbladder disease, and
damage to the spleen.
Pneumothorax: air in the pleural space, occurring spontaneously or from
trauma.
External splinting of the chest wall and pain medication can reduce the pain
of pleurisy. Treatment of the underlying disease, of course, ultimately relieves
the pleurisy.
If the pleural fluid shows signs of infection, appropriate treatment involves
antibiotics and drainage of the fluid. If there is pus inside the pleural space,
a chest drainage tube should be inserted.
Congestive heart failure (CHF) is a condition in which the heart's function as a pump is inadequate to meet the body's needs. A poor blood supply resulting
Lymph nodes help the body's immune system fight infections. Causes of swollen lymph nodes (glands) may include infection (viral, bacterial, fungal, parasites).
Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis bacteria. Symptoms include weakness, fever, weight loss, night sweats and
Pneumonia is inflammation of one or both lungs with consolidation. Pneumonia is frequently but not always due to infection. The infection may be bacterial,
Systemic lupus erythematosus is a condition characterized by chronic inflammation of body tissues caused by autoimmune disease. Lupus can cause disease
Gallstones are stones that form when substances in the bile harden. Gallstones (formed in the gallbladder) can be as small as a grain of sand or as large
Breast cancer is the most common cancer in women and the second most common cause of cancer death in women in the U.S. Symptoms include a lump in the breast
Ascites, the accumulation of fluid in the abdominal cavity is most commonly caused by cirrhosis of the liver. Some of the other causes of ascites include
A pulmonary embolism occurs when a piece of a blood clot from deep vein thrombosis (DVT) breaks off and travels to an artery in the lung where it blocks
The spleen enlarges if it is asked to do excessive work in filtering or manufacturing blood cells, if there is abnormal blood flow to it, or if it is invaded
Chronic cough is a cough that does not go away and is generally a symptom of another disorder such as asthma, allergic rhinitis, sinus infection, cigarette
A pneumothorax is free air in the chest outside the lung, that causes the lung to collapse (collapsed lung). There are two types of pneumothorax, spontaneous
Pulmonary edema (swelling or fluid in the lungs) can either be caused by cardiogenic causes (congestive heart failure, heart attacks, abnormal heart valves)
Pleural effusion is an excess fluid between the two membranes that envelop the lungs. There are two classifications of causes of pleural effusion; transudate
Chest pain is a common complaint by a patient in the ER. Causes of chest pain include broken or bruised ribs, pleurisy, pneumothorax, shingles, pneumonia,
Fractures occur when bone cannot withstand the outside forces applied to the bone. Fractures can be open or closed. Types of fractures include: greenstick,
Asbestos exposure lung disease is divided into three main types, asbestosis (lung scarring caused by asbestos fibers), disease of the lining of the lung
Mesothelioma is a form of cancer that forms in the chest lining (pleural mesothelioma), abdomen (peritoneal mesothelioma), and the heart sac (pericardial
Pulmonary embolism is a diagnosis that should be considered in patients with
chest pain and/or shortness of breath, and is one of the causes of sudden death.
