Chest pain and exacerbations of bronchiectasis

Abstract

Background: Bronchiectasis is a common disease and a major cause of respiratory morbidity. Chest pain has been described as occurring in the context of bronchiectasis but has not been well characterized. This study was performed to describe the characteristics of chest pain in adult bronchiectasis and to define the relationship of this pain to exacerbations.

Subjects and methods: We performed a prospective study of 178 patients who were followed-up for 8 years. Subjects were reviewed on a yearly basis and assessed for the presence of chest pain. Subjects who had chest pain at the time of clinical review by the investigators were included in this study. Forty-four patients (25%) described respiratory chest pain at the time of assessment; in the majority of cases 39/44 (89%), this occurred with an exacerbation and two distinct types of chest pain could be described: pleuritic (n = 4) and non-pleuritic (n = 37), with two subjects describing both forms. The non-pleuritic chest pain occurred most commonly over both lower lobes and was mild to moderate in severity. The pain subsided as patients recovered.

Conclusion: Non-pleuritic chest pain occurs in subjects with bronchiectasis generally in association with exacerbations.

Keywords: airway obstruction; bronchitis; collapse; sputum.

Figure 1

(A) Chest X-ray showing atelectasis in the lingular segment of the left lung. The subject complained of typical non-pleuritic aching chest pain over the left upper chest, as described in this article. (B) Follow-up X-ray showing resolution of atelectasis.

Figure 2

(A) High-resolution computed tomography (CT) scan showing left basal atelectasis/bronchiectasis. The patient complained of acute onset of bilateral non-pleuritic lower chest pain. (B) Follow-up CT showing with resolution of symptoms.