The site of pain in pleurisy is the lateral chest wall. This is because the lateral chest wall has the greatest extent of contact between the wall pleura and the dirty pleura, and also the greatest extent of friction. The pain is characterized by a significant pain when coughing or deep inspiration, due to the fact that the friction is more intense when these movements are performed. When pleural fluid develops in pleurisy, the pain disappears instead, followed by chest tightness and shortness of breath. When a large amount of pleural fluid is reached, dyspnea may also occur, at which time closed chest drainage or thoracentesis is required to drain out the excess pleural fluid to relieve the pressure on the heart and lungs.