Pain when taking a deep breath

[Myrae]

I am a 25 years old female, smoker. About 2 or 3 weeks ago, I had a burning kind of pain in my right upper chest while smoking for a week, but it was gone completely. For two days now, I have been smoking too much due to my anxiety problems and the pain has appeared again, even worse. When I take a deep breath, there is a sharp internal pain in my very upper chest, on the right side. I don't have any other lung or breath problems. What do you think this can be? Thanx in advance.

[John Kenyon, CNA]

Hi there -

What you're describing is not heart related, but sounds exactly like pleurisy, which of course (I even hate to say this) is probably being worsened by the increase in smoking and may actually be due to smoking. No lecture, you know what you need to do with that.

Pleurisy or pleuritic pain, is due to irritation or inflammation of the pleura, the membrane lining the space between the lungs and the chest wall. Sometimes it also involves the chest wall itself. It can be caused by a mild viral infection, lung irritation, or due to random irritating causes. The pain can be felt in the side from the bottom of the ribs upward on inspiration and often will shoot up into the shoulder or the area of the collar bone. It can be excruciating and inhibit normal breathing, which over time can lead to pneumonia, just FYI. Usually this doesn't happen, and sometimes pleurisy actually is the main symptom of a mild pneumonia.

Pleuritic pain usually responds well to non-steroidal anti-inflammatory (NSAID) pain meds like ibuprofin (as Advil) or naproxyn (as Aleve). If this doesn't resolve the problem or if it recurs, you should have this checked by a doctor to make sure there's no underlying lung problem. Usually it will resolve on its own, more quickly with NSAID therapy.

I hope this helps. Please follow up with us as needed.

[Myrae]

Oh, thx for your quick reply. Yes, I feel it towards my collar bone area and even near the right side of my very upper esophagus (nearly my throat), a strange area that I can not identify accurately. When I deep breathe for a few times or smoke a cigarette, I somehow aggravate it and it burns on its own for a few minutes. I will make an appointment with my doc soon, and have an x-ray maybe. I will keep you updated, thx again.

[Myrae]

An update to my question; can pleurisy occur only in the area where I am talking about? Because I feel a very localized pain, limited only to my right upper chest as I mentioned before. I don't have anything in the middle or bottom. I'm very worried about malignant possibilities, this is why I am asking so many details. Thank you..

[John Kenyon, CNA]

Hi again -

Thanks for the reply and update. To answer your followup question, most pleuritic pain is referred upward, so often the origin is lower in the chest wall area, but is felt very distinctly in the locale you describe. This is especially common with pain in the thorax, where a lot of the nerves wander around in peculiar patterns. It probably is localized, but probably not where it is felt, although of course that's possible too. Usually the actual site of irritation is lower down. It can be anywhere along the trunk of the nerve and will usually always be felt mainly up high as you describe.

Hope this helps.

[Myrae]

Hi,
I'm more relaxed now. But I may have a chest x-ray if this continues to bother me.

Thanks for your interest.

[Myrae]

Hi again,

I had a blood work and chest x-ray two days ago. Everything is normal. I still don't have any other symptoms, but I still have a pain in my right upper chest (an inner pain parallel to my manubrium, between the 1st and the 2nd ribs I think) in the end of a deep breath. Do you think this can be something related to any malignancies?

Thanks in advance.