Pleural Effusion

What is a pleural effusion?

A pleural effusion is when fluid collects in between the two linings of the lung (pleura). This can occur due to many different reasons. The symptoms of pleural effusion can include shortness of breath, cough, and even pain with breathing.

What causes pleural effusions?

The most common causes of watery (transudative) pleural effusions include heart failure, pulmonary embolism, cirrhosis, and post-surgery. The most common reasons for protein rich fluid (exudative) includes pneumonia, cancer, pulmonary embolism, kidney disease and inflammatory diseases.

What is the treatment for pleural effusions?

After the pleural effusion has been diagnosed on a chest x-ray or CT scan, the fluid usually will be drained with a small needle to send to the lab to identify a cause. This is called a thoracentesis. If there is an obvious reason for the effusion or there is a contraindication for drainage, then diuretic treatment can be tried. Once a cause is identified, the underlying disease can be treated. In the case of refractory effusions or malignancy, a semi-permanent drainage tube called a “pleurX” catheter may be placed for repeated drainages. Another option for refractory effusions is called pleurodesis which is where an irritant substance (usually talc) is instilled into the pleural space to help close off the space preventing further fluid accumulation.

What can I expect at my first visit at PCCS?

A thorough history and physical is performed. Usually a chest x-ray and sometimes pulmonary function testing is performed. If the patient is symptomatic or a diagnosis is required then a thoracentesis will be performed by our doctor on that date (or scheduled later) in our office. The fluid is then sent to our lab for further analysis.