What is it?

A pleural effusion is an accumulation of fluid within a cavity called the pleural space. The pleural space is located between the two layers of pleura, which are thin layers that wrap the lungs and chest wall, sliding over each other while breathing and allowing the lungs to expand and empty properly. When fluid accumulates within this cavity, lung function may be impaired. There are many reasons that can cause pleural effusion. Common causes are heart dysfunction (heart failure), pulmonary embolism, pneumonia, lung cancer, kidney failure, liver failure and inflammatory diseases.

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Additional names

This group contains additional names:
- Chylothorax
- Loculated pleural effusion
- Chylous effusion
- Fluid around lung

Signs & symptoms

A small pleural effusion may not cause any symptoms. Large pleural effusion may cause respiratory symptoms, such as shortness of breath and pleuritic pain (chest pain that occurs during inhalation). Additional symptoms may be present depending on the underlying cause of the pleural effusion. For example, pleural effusion caused by pneumonia may be accompanied by fever and cough, while pleural effusion caused by heart failure may be accompanied by exertional chest pain and swollen ankles and legs.

Diagnosis

Diagnosis of pleural effusion is made by a physical examination by a doctor, followed by an imaging of the chest using ultrasound, chest X-ray or chest CT. The next step will be to diagnose the cause of the pleural effusion. To do this a sample of the fluid will be taken in a process called Thoracentesis. In this procedure, a needle is inserted between the ribs and the fluid is aspirated.

Treatment

Treatment for pleural effusion focuses primarily on the underlying cause. For example, heart failure is treated with diuretics that help get rid of excess fluid, including that which has accumulated in the pleural space. Bacterial pneumonia, on the other hand, is treated with antibiotics. In some cases, in addition to treating the underlying cause, drainage of the fluid will also be needed (by preforming repeated fluid aspirations or by inserting a chest tube).

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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