Pleural Effusion

Pleural Effusion is the buildup of excess fluid in the space between the pleura. The pleura are two thin, moist membranes around the lungs. There are two layersof pleura:
  • Inner layer – attached to the outside of the lungs
  • Outer layer – lines the inside of the ribcage
There are two types of effusion: transudative and exudative. In both cases, the excess fluid prevents the lungs from fully expanding, and causes shortness of breath.

Causes

Effusion is usually caused by disease or injury. The two types have different causes: Transudative:
  • Heart failure
  • Malnutrition
  • Liver disease
  • Kidney disease
Exudative:
  • Tuberculosis
  • Pneumonia
  • Cancer

Risk Factors

A risk factor is something that increases your chances of getting a disease or condition.
  • Pneumonia, tuberculosis, or other lung diseases
  • Heart attack, heart failure, or infections such as pericarditis
  • Inflammation or infection of the pleura
  • Liver disease
  • Connective tissue diseases, such as rheumatoid arthritis and lupus
  • Certain medications:
    • Nitrofurantoin
    • Dantrolene
    • Methysergide
    • Bromocriptine
    • Procarbazine
    • Amiodarone
  • Cancers, such as lung, breast, lymphoma, or mesothelioma
  • Chest injury or trauma
  • Radiation therapy
  • Pulmonary embolus (blood clot in the lungs)
  • Abdominal infections or pancreatitis
  • Surgery, especially involving
    • Heart
    • Lungs
    • Abdomen
    • Organ transplantation

Symptoms

Symptoms may include:
  • Shortness of breath
  • Chest pain
  • Stomach discomfort
  • Cough
  • Coughing up blood
  • Shallow breathing
  • Rapid pulse or breathing rate
  • Weight loss
  • Fever, chills, or sweating

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. This may include listening to or tapping on your chest.
Tests may include:
Chest X-ray – a test that uses radiation to take a picture of structures inside the chest
Ultrasound – a test that uses sound waves to examine structures inside the chest
CT Scan – a type of x-ray that uses a computer to make pictures of structures in the chest
Thoracentesis – fluid sample extracted from the pleural space around the lungs with a needle
Pulmonary Function Tests — to check breathing ability
Biopsy – removal of a sample of pleural tissue for testing

Treatment

Treatment is usually aimed at treating the underlying cause. If breathing is impaired, breathing treatments or supplemental oxygen may be given. The Pleural Effusion may be drained using a chest tube inserted into the side of your chest. In some cases, the doctor may recommend chemical pleurodesis. During this procedure a chemical is injected into the pleural space to permanently seal the two layers of the pleura together. This may help prevent further fluid build-up.

Prevention

The best way to prevent Pleural Effusion is to get prompt treatment for any condition that may lead to pleural effusion.