Pleural effusion

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Pleural effusion
Synonyms	"Water on the lungs"
Pronounce
Specialty	Pulmonology
Symptoms	Shortness of breath, chest pain, cough
Complications	Pneumothorax, empyema
Onset
Duration
Types	Transudative effusion, exudative effusion
Causes	Heart failure, pneumonia, cancer, pulmonary embolism
Risks
Diagnosis	Chest X-ray, ultrasound, CT scan, thoracentesis
Differential diagnosis	Pneumonia, congestive heart failure, lung cancer
Prevention
Treatment	Thoracentesis, pleurodesis, chest tube
Medication	Diuretics, antibiotics
Prognosis
Frequency
Deaths

Accumulation of fluid in the pleural cavity

Pleural Effusion

Pleural effusion is a medical condition characterized by the accumulation of excess fluid between the layers of the pleura outside the lungs. The pleura are thin membranes that line the lungs and the inside of the chest cavity and facilitate smooth respiratory movements.

Pathophysiology

Pleural effusion occurs when there is an imbalance between the production and absorption of pleural fluid. Normally, a small amount of fluid is present in the pleural space to lubricate the surfaces of the pleura. However, various conditions can lead to an increase in fluid production or a decrease in fluid absorption, resulting in pleural effusion.

Causes

Pleural effusion can be caused by a variety of conditions, which are generally classified into transudative and exudative effusions based on the protein content and other characteristics of the fluid.

Transudative Effusions

Transudative effusions are usually caused by systemic factors that alter the pressure in the pleural space, such as:

• Congestive heart failure
• Cirrhosis
• Nephrotic syndrome
• Hypoalbuminemia

Exudative Effusions

Exudative effusions are typically due to local factors affecting the pleura, such as:

• Pneumonia
• Malignancy
• Pulmonary embolism
• Tuberculosis
• Rheumatoid arthritis

Symptoms

The symptoms of pleural effusion can vary depending on the underlying cause and the amount of fluid present. Common symptoms include:

• Dyspnea (shortness of breath)
• Chest pain
• Cough
• Reduced breath sounds on the affected side

Diagnosis

The diagnosis of pleural effusion typically involves a combination of clinical evaluation and diagnostic tests. These may include:

• Chest X-ray
• Ultrasound
• CT scan
• Thoracentesis (to analyze pleural fluid)

Treatment

Treatment of pleural effusion depends on the underlying cause and the severity of the condition. Options may include:

• Therapeutic thoracentesis to remove excess fluid
• Treatment of the underlying condition (e.g., antibiotics for pneumonia)
• Pleurodesis for recurrent effusions
• Surgical interventions in certain cases

Prognosis

The prognosis of pleural effusion varies widely depending on the underlying cause and the patient's overall health. Some effusions resolve with treatment of the underlying condition, while others may require ongoing management.

See also

• Pleura
• Respiratory system
• Pulmonary embolism
• Pneumonia