Pleural effusion

INDEX:

1. What is pleural effusion?
2. Symptoms of the disease
3. What are the causes?
4. Prevention
5. How is it treated?

What is pleural effusion?

During a pleural effusion, the pleural space (between the lungs and the chest) is filled with excess fluid. Although there is usually some fluid in this area, if a pleural effusion occurs there is more fluid than normal.

In most cases in which there is excess fluid in the thorax, both lungs are usually affected, the most common etiology being heart failure.

Pleural effusion is divided into two types, according to its origin:

1. Transudate: The fluid leaks due to elevated blood pressure. In these cases, the pleura is healthy. It is usually caused by heart failure and, in some cases, by cirrhosis of the liver.
2. Exudate: The origin varies, although the most frequent are: blockage of vessels, tuberculosis, pneumonia, lung lesions or tumors.

There are also cases of malignant effusion, related to lung tumors.

What are the symptoms?

Although in some cases patients with pleural effusion have no symptoms, these may include:

• Chest pain, usually sharp and worsened by coughing or deep breathing.
• Cough
• Fever
• Hiccups, which occur because of involuntary movement of the diaphragm
• Rapid breathing
• Shortness of breath

What are the causes of pleural effusion?

The causes may be:

• Heart failure, which is an imbalance between the body’s needs and the heart’s ability to pump blood.
• Systemic diseases, such as hypertension.
• Benign gynecological and digestive tract diseases, such as endometriosis or ovarian hyperstimulation, which can cause pulmonary effusions. Regarding digestive pathologies, some of them can be pancreatic pseudocysts.
• Various cancers.
• Liver diseases, such as cirrhosis.
• Some medications
• Tuberculosis
• Pneumonia
• Abdominal or thoracic surgeries that, in some cases, cause pleural effusion.

Can it be prevented?

Pleural effusion could be prevented by treating the cause that produces it, which can avoid its appearance. For this, early diagnosis and treatment will be very important.

If it is confirmed that there is fluid in the lung, it is possible to foresee what may occur and place a drain to eliminate the fluid early.

What does the treatment consist of?

If there is fluid in the pleura, the objective will be to drain it, prevent it from accumulating again and try to find out what caused it. The most commonly used technique to remove the fluid is thoracentesis, eliminating the pressure in the thorax and allowing it to expand.

Subsequently, treatment will depend on the type of pleural effusion: transudate or exudate. Thus, diuretics will be the mainstay of treatment in transudative pleural effusion, as they are effective in heart failure. On the other hand, if the effusion is exudate, it will be important to treat the origin, antibiotics being an effective option.

On the other hand, in patients with cancer, a chest tube is usually used for days to remove the fluid from the lung. This treatment will be combined with chemotherapy or radiotherapy and, in specific cases, with surgery.