Pleural Effusion: A Brief Explanation

Dr.Akshay Budhraja, 2 mins read

Pleural effusion is the excess fluid buildup in the pleura, the space between the lungs and chest cavity. Normally, the pleura has a small amount of fluid to facilitate lung expansion and contraction while breathing.

However, too much fluid buildup in the pleura causes chest pain and breathing problems. This generally happens when the body produces excess fluid and doesn’t absorb it appropriately.

Causes:

Pleural effusion can result from various conditions. Depending on the cause, the excess fluid can be protein-rich (exudative) or protein-poor (transudative). These two categories help your doctor find the cause.

Common causes of exudative pleural effusion:

• Tuberculosis
• Pneumonia
• Lung, breast, or lymphoma cancers
• Kidney disease
• Inflammatory disease
• Post-open heart surgery

Common causes of transudative pleural effusion:

• Cirrhosis
• Heart failure
• Nephrotic syndrome

Some other reasons can also cause pleural effusion. These include:

• Autoimmune diseases like lupus and rheumatoid arthritis
• Certain medications
• Pancreatitis
• Radiation therapy
• Rupture of esophagus
• Some chest and abdominal infections
• Abdominal surgery
• Bleeding from chest trauma
• Chylothorax
• Meigs’s syndrome
• Ovarian hyperstimulation syndrome

When to seek medical attention?

You may not have any symptoms initially. But as the disease progresses to moderate and severe levels, you may experience:

• Chest pain that worsens with deep breathing or coughing
• Shortness of breath
• Cough
• Fever

If you are experiencing these symptoms, consult a doctor to evaluate the problem and receive prompt treatment.

Diagnosis:

Your doctor will examine your medical history and evaluate your symptoms. If the doctor suspects the symptoms of pleural effusion, you will be recommended on some tests:

• Chest X-ray
• Chest CT-scan
• Chest ultrasound
• Pleural fluid analysis
• Biopsy or thoracentesis

If these tests don’t help, you may be recommended a thoracoscopy. Thoracoscopy is a minimally invasive procedure that allows the doctor to see and treat the effusion.

Treatment:

Treatment depends on the underlying cause and severity:

• Medicines: You may be recommended medication for the management of the underlying problem. For instance, diuretics for congenital heart problems, antibiotics for pneumonia, and chemotherapy/radiation therapy for malignant effusion.
• Therapeutic thoracentesis: Drainage of excess fluid using a needle or catheter.
• Tube thoracostomy: A small procedure to fix a flexible tube into the chest for some days to drain the excess fluid.
• Pleural drain: This is done when the pleural effusion is continuous. A doctor fixes a long-term catheter through your skin to allow patients to drain excess fluid at home.
• Pleurodesis: An agent is injected into the pleural space to adhere the lungs to the chest wall. This eliminates the pleural space that prevents recurrence of pleural effusion in many cases.
• Pleural decortication: Surgeons operate inside the pleural space to remove unhealthy cells.