What Is Pleural Effusion? Symptoms, Diagnosis and Treatment

What Is Pleural Effusion?

Pleural effusion is the abnormal accumulation of fluid between the pleural membranes surrounding the lungs. It is sometimes described as “fluid around the lung.”

What Causes Pleural Effusion?

The pleural membranes allow the lungs to move smoothly inside the chest wall during breathing. In healthy individuals, there is a very small amount of lubricating fluid between these two layers. However, in conditions such as infections, heart failure and lung cancer, the amount of fluid may increase and breathing function may be affected.

• Lung infections such as pneumonia
• Tuberculosis
• Lung cancer or metastasis
• Heart failure
• Pulmonary embolism
• Rheumatic diseases such as lupus or rheumatoid arthritis
• Some medication reactions or trauma

Pleural effusion is generally a sign of another disease. Identifying the underlying cause is therefore essential for diagnosis and treatment planning.

What Are the Symptoms of Pleural Effusion?

The severity and duration of symptoms may vary depending on the underlying disease. Some small pleural effusions may cause no symptoms, while complaints may become more apparent as the amount of fluid increases.

One of the common symptoms is sharp chest pain during breathing. This pain is often one-sided and may worsen with deep breathing, coughing or movement. Shortness of breath becomes more noticeable as fluid accumulation increases. Dry cough, fatigue and fever may also accompany the condition.

If chest pain and shortness of breath are present, medical evaluation should not be delayed.

How Is Pleural Effusion Diagnosed?

After evaluating the patient’s complaints and examination findings, the physician may request various tests.

• In patients presenting with chest pain or shortness of breath, one of the initial imaging methods may be a chest X-ray. It may show fluid between the pleural membranes.
• To clarify the diagnosis and assess the location and amount of fluid, chest ultrasound or computed tomography (CT) may be used.
• An important part of diagnosis is thoracentesis. During this procedure, fluid in the pleural space is removed with a thin needle and analyzed for possible causes such as infection, cancer or tuberculosis.
• Blood tests and sputum culture may be performed when necessary.

Early diagnosis is important for identifying the underlying disease and planning appropriate treatment.

How Is Pleural Effusion Treated?

Treatment is planned according to the underlying disease. The patient’s general condition, pain, shortness of breath and the amount of fluid are considered when planning symptomatic and cause-directed treatment.

1. If it develops due to infection, antibiotics may be used when considered appropriate by the physician.
2. In tuberculosis-related cases, long-term anti-tuberculosis medications are used.
3. In cancer-related pleural effusion, oncologic treatments, fluid drainage procedures or recurrence-prevention methods may be considered.
4. If excess fluid in the chest cavity makes breathing difficult, it may be drained with a procedure called thoracentesis.
5. If fluid repeatedly accumulates, pleurodesis may be considered in suitable patients to help reduce recurrent fluid buildup by sealing the pleural layers together.

Frequently Asked Questions

References

1. Cleveland Clinic. Pleural Effusion: Symptoms, Causes & Treatment
2. Cleveland Clinic. Pleurodesis: Procedure, Types & Recovery
3. Merck Manual Consumer Version. Pleural Effusion
4. Merck Manual Professional Edition. Pleural Effusion