Pleural effusion is a condition where there is abnormal fluid in the pleural cavity. You need to know, the pleura is a thin membrane that lines the lungs and chest wall.
Although they both attack the lungs and are associated with abnormal fluid, pleural effusion is different from wet lungs.
Wet lung disease occurs due to an infection that causes inflammation of the alveoli or air sacs in the lungs.
Between the pleura lining the lungs and the chest wall, there is a pleural cavity.
Normally, there is a small amount of fluid in this cavity which functions as a lubricant between the two pleurae when the lungs move when breathing.
This condition can be mild or serious depending on the cause. Viral infections, pneumonia, and heart failure are some of the conditions that can cause this condition.
Symptoms of Pleural Effusion
Some people with it have no symptoms and the condition is detected during a chest X-ray performed for another reason.
If symptoms do occur, the sufferer will experience symptoms unrelated to the condition and experience symptoms of the disease-causing the effusion.
Symptoms generally begin to appear when the pleural effusion is moderate to severe or when inflammation has occurred.
This condition can then cause the following symptoms:
- Dry cough.
- Fever.
- Difficulty breathing especially when lying down. Also, if you have symptoms of Frequent Shortness of Breath, Beware of Pleural Effusion.
- Chest pain when inhaling and exhaling.
- Hard to breathe.
Causes of Pleural Effusion
There are various causes of this condition, some of the most common causes include:
- Leakage into other organs. This usually occurs if someone has congestive heart failure when the heart is not pumping blood to the body properly. However, it can also be caused by liver or kidney disease, when fluid builds up in the body and leaks into the pleural cavity.
- Cancer. Lung cancer is usually the cause of this condition. However, other cancers that have spread to the lungs or pleura can also be the cause.
- Infection. Some diseases that cause this condition are pneumonia or tuberculosis.
- Autoimmune conditions. Lupus or rheumatoid arthritis are some diseases that can cause pleural effusion.
- Pulmonary embolism. Occurs due to blockage of an artery in one of the lungs and can cause pleural effusion.
Types of Pleural Effusion
This condition is divided into two types, namely:
-
Transudative
The cause of this type is leakage of fluid into the pleural cavity due to increased pressure on the blood vessels.
This can happen if:
- Having congestive heart failure.
- Suffering from cirrhosis.
- Have kidney disease.
- Just had peritoneal dialysis procedure.
- Experiencing malnutrition due to low levels of albumin in the blood.
-
Exudative
This type of effusion occurs when fluid builds up due to:
- Inflammation.
- Infection.
- Tumor.
Conditions that can cause this type of effusion include:
- Tuberculosis (TB).
- Cancer.
- Inflammatory conditions, such as pancreatitis, lupus, or rheumatoid arthritis.
- Complications from heart surgery.
- Chylothorax, which is caused by blockage of the lymph vessels.
- Pneumonia.
- Hemothorax, when blood collects in the pleural cavity.
Risk Factors
Some risk factors that increase a person’s risk of suffering from pleural effusion include:
- Having a history of high blood pressure (hypertension), smoking, consuming alcoholic beverages, or being exposed to asbestos dust. Also, read more in this article: Having High Blood Pressure Can Cause Pleural Effusion.
- Undergoing treatment or medication for a cancer that affects the way the body retains fluid.
- Low protein in the blood can cause fluid to easily leak out of the blood vessels and collect in the pleural cavity, for example due to liver cirrhosis or kidney disease.
- Decreased absorption rate from the lymphatic system, for example due to blockage of the lymphatic system due to malignancy or trauma.
- Certain medications, abdominal surgery and radiation therapy can also cause this condition.
Diagnosis
The doctor will diagnose pleural effusion by conducting a medical interview, physical examination, and supporting examinations, such as:
- Chest X-ray. Through a chest X-ray examination, this condition will appear white on the X-ray, while the air space looks black.
- Computed tomography (CT-Scan). Compared to chest X-rays, CT-Scan examinations can show lung conditions in more detail.
- Ultrasonography. The doctor may perform an ultrasound to find the fluid.
- Thoracentesis. Thoracentesis or pleural puncture is a procedure that involves taking a sample of fluid using a needle into the pleural cavity, to examine the type of fluid in the laboratory.
Pleural Effusion Treatment
The main treatment is to cure the condition that causes the pleural effusion itself.
If the cause of pleural effusion is an infection, treatment is with antibiotics.
If the cause is a malignancy or cancer, the treatment is with radiotherapy or chemotherapy.
Some common actions that doctors take to treat this condition include:
-
Thoracentesis
If the effusion is large, your doctor may take some fluid for testing. However, this treatment is only to relieve symptoms.
-
Thoracostomy tube (chest tube)
The procedure involves making a small incision in the chest wall, and the doctor then inserts a tube into the pleural space for several days.
-
Pleural drainage
If symptoms persist or recur, your doctor may place a long-term catheter through the skin into the pleural space.
Then, you can drain the pleural effusion at home. Your doctor will tell you how and when to do it.
-
Pleurodesis
This procedure involves injecting an irritating substance (such as talc or doxycycline) through a chest tube into the pleural space.
The substance inflames the pleura and chest wall, which then bind tightly to each other during the healing process.
In most cases, pleurodesis can prevent this condition from coming back.
-
Pleural decortication
A surgical specialist can operate inside the pleural cavity, removing potentially dangerous inflammation and unhealthy tissue.
To perform this procedure, the surgeon may make a small incision (thoracoscopy) or a large incision (thoracotomy).
Complications of Pleural Effusion
Conditions left untreated can lead to the following conditions:
- Atelectasis, which occurs when the alveoli do not fill with air and causes lung damage.
- Empyema, which is the accumulation of pus in the pleural cavity.
- Pneumothorax is caused by the accumulation of air in the pleural cavity.
- Thickening of the pleura and the appearance of scar tissue in the lining of the lungs.
Prevention of Pleural Effusion
Pleural effusion is a condition caused by a certain disease, so it is often difficult for you to prevent it.
