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Pleural Effusion

  • The lining of the chest cavity (pleura)

Definition

A pleural effusion is an abnormal collection of fluid around the lungs.

What is going on in the body?

Normally, a very small amount of fluid surrounds the lungs, keeping them lubricated. This fluid allows the lungs to collapse and expand easily when a person breathes. Sometimes, the amount of fluid increases to an abnormal level, called a pleural effusion. This can happen for various reasons.

Risks

What are the causes and risks of the condition?

There are a number of causes for pleural effusion. These can include:
  • congestive heart failure (CHF). In this condition, the heart that does not pump strongly enough, causing fluid to collect in the lungs.
  • infection, such as pneumonia or tuberculosis
  • low protein levels in the body
  • cancer inside or next to the lungs
  • inflammation in or near the lung, including an inflammation of the lung lining called pleurisy. This is most commonly due to pneumonia, but can also be caused by autoimmune disorders, such as rheumatoid arthritis, as well as other diseases.
  • trauma or injury to the chest, such as a crush injury
  • kidney failure, or chronic renal failure

Prevention

What can be done to prevent the condition?

Pleural effusion from congestive heart failure can be prevented by taking prescribed medications and adhering to a diet low in sodium. Lung cancer, which may cause pleural effusion, can be prevented by not smoking in most cases. Many cases of pleural effusion cannot be prevented.

Diagnosed

How is the condition diagnosed?

The healthcare provider will review the person's symptoms, perform a physical exam, and do a chest x-ray. Pleural effusions can also be found on chest CT and MRI exams.

Long Term Effects

What are the long-term effects of the condition?

If a pleural effusion is not treated, more fluid may accumulate. This may result in serious breathing problems. The underlying condition causing the pleural effusion may result in permanent lung damage.

Other Risks

What are the risks to others?

Some infections that cause pleural effusion, such as pneumonia or tuberculosis, can be passed to others.

Treatments

What are the treatments for the condition?

Treatment for pleural effusion depends on the underlying cause of the condition. Congestive heart failure can be treated with medications. Infections can be treated with antibiotics. Inflammation can be treated with medications to reduce inflammation. In all of these cases, the effusion will often go away after treatment. For cancer and trauma, the fluid often must be drained. A tube is inserted through the skin and into the chest cavity for this procedure. Surgery and chemotherapy may also be needed to treat the underlying cause of the pleural effusion in these cases.

Side Effects

What are the side effects of the treatments?

Medications can cause side effects such as allergic reactions and stomach upset. Specific side effects depend on the medication used. Surgery and insertion of a tube into the chest carry the risk of bleeding, infection, and death.

After Treatment

What happens after treatment for the condition?

If the underlying condition is successfully treated and the effusion clears up, the person can return to normal activities. If the underlying condition is not remedied or the effusion remains, further treatment and monitoring are needed.

Monitor

How is the condition monitored?

The condition is generally monitored with repeat physical examinations and chest x-rays.

Sources

Cecil's Textbook of Medicine, 1996, Bennett et al

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