What Are the Treatments for Pleurisy After Heart Attack?

Any medical condition, event or procedure poses the risk of possible complications. A heart attack is a major medical event in which the heart muscle is damaged. Complications that result can range from relatively insignificant to life threatening. Rapid recognition and treatment aid in the prevention of long-term consequences as a result of complications. Pleurisy is one of the many complications that can follow a heart attack.

Pleurisy

• To effectively treat a complication, it is necessary to understand its cause. Pleurisy occurs when the lining covering the lungs and chest cavity becomes inflamed. When a heart attack occurs, the damaged heart releases chemicals that the body's immune system does not recognize. Consequently, it instructs the body's "army" to fight the substances it perceives as being foreign. The pleura is just one of the structures that may become inflamed as a result of the assault. Symptoms of pleurisy may include chest pain when inhaling and exhaling, shortness of breath, a dry cough and chills and fever.

Inflammation

• Since pleurisy is caused by inflammation, treatment is aimed at stopping the immune system's misdirected attack. This is accomplished using drugs that are known to be anti-inflammatory. Anti-inflammatory drugs used to treat pleurisy following a heart attack include non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. Though each class of anti-inflammatory drugs possesses a unique mechanism of action, the result is the same. Each type of drug has its advantages and disadvantages.

NSAIDs

• NSAIDs that may be used to treat pleurisy following a heart attack include aspirin, ibuprofen and naproxen. NSAIDs are the drugs of choice for reducing the inflammation responsible for pleurisy. The side effects they cause are far less serious than those caused by other anti-inflammatory drugs. In addition to reducing inflammation, they also serve to reduce the pain that accompanies pleurisy. Long-term use of NSAIDs can cause gastrointestinal distress, ulcers and, in some cases, stomach perforation.

Corticosteroids

• When NSAIDS prove to be ineffective against pleural inflammation, a corticosteroid, usually prednisone, is prescribed. The effectiveness of prednisone as an anti-inflammatory is well documented. Unfortunately, its side effects can be serious, so its use is reserved for situations in which the benefits of its use outweigh the risks. Side effects associated with prednisone use include stomach irritation, insomnia, mood changes and headache. Long-term use may cause weight gain, fluid retention, osteoporosis, thin skin and cataracts. Corticosteroids may also interfere with the body's ability to heal itself following a heart attack.

Colchicine

• Colchicine is a substance derived from the autumn crocus flower. Originally approved by the FDA for the treatment of gout, colchicine has proven to reduce the pleural inflammation that sometimes accompanies heart attack. Like corticosteroids, colchicine can produce serious side effects. The possibility of liver and kidney damage as a result of this drug prohibits its use with certain individuals. It may also cause a temporary reduction in the number of white blood cells.