In normal conditions, our lungs are covered by two layers called pleura, which separate and protect the lungs from structures around it. Between these two layers, some amount of fluid is present, which lubricates the layers, while they rub against each other during breathing.

Pleural effusion is a condition, in which excessive fluid, accumulates between the layers of the lungs.


What are the symptoms of pleural effusion?

The symptoms can be shortness of breath, difficulty in breathing, cough which usually dry and chest pain. There may be unrelated symptoms due to diseases that may have caused the effusion.


What is the difference between pleural effusion and pulmonary edema?

In both condition there is excess of fluid in normal lung spaces. Pleural effusion is fluid between the layers covering the lung and pulmonary edema is fluid in the lung air sacs.

Although symptoms might overlap, a history of presentation, physical examination and radiological findings helps in differentiating the two conditions.


What causes pleural effusion?

Pleural effusion is a manifestation of complication of underlying diseases.  It can develop in severe infection, such as pneumonia (chest infection), complication of heart, liver, kidney or pancreatic disease. It can also develop in patients suffering from cancer.


How is it diagnosed?

A simple chest x-ray aids in making diagnosis of pleural effusion. For further evaluation ultrasound of chest or CT scan of the chest can be done. A diagnostic pleural fluid aspiration/ tap can be done. In this method only small amount of fluid is removed and send for certain tests, to determine the cause of pleural effusion.


Is it treatable?

In order to treat pleural effusion, the underling disease causing effusion must be treated. If the effusion is small, it will regress as the primary problems gets treated. Sometimes the size of the effusion is large, and this requires to be removed by some invasive method. Pleural fluid aspiration is a procedure in which fluid is removed with a large bore needle. Maximum amount of fluid is drained out, which gives symptomatic relief to the patient and the fluid is send for laboratory analysis to help in determining the cause. In more complicated or recurrent situation, a chest tube is kept placed into the pleural space. The tube is attached to special drainage container, which collects the fluid via gravity or suction.

These procedures are performed by pulmonologists or interventional radiologists under strict aseptic techniques to .

A more invasive approach is VATS, video assisted thoracic surgery. This is performed when pleural effusion is recurrent, or is not localized to one side but is present in multiple pockets.  It is a procedure performed by a cardiothoracic surgeon. A small camera and surgical instruments are passed through the incisions made on the chest wall.


Can it reoccur?

Yes, in certain condition like cancers, pleural effusion can reoccur. Patients suffering from kidney, heart or liver failure can also developed recurrent pleural effusion.


Is pleural effusion life threatening?

Large pleural effusions can lead to severe respiratory distress. Patient finds it difficult to breath, oxygen levels decreases and in certain situation support of non-invasive or invasive ventilator is needed.


Should you need to see a pulmonologist or critical care Intensivist, please call The Chest Clinic- Dr. Javed Husain & Associates. We offer both online video consultation as well as outpatient clinic and in-hospital care for all our patients. To make an appointment please call +923018479066 or leave us a message by WhatsApp requesting an appointment and a member of our team will call back and connect with you.