Pleural Effusion Overview
Pleural effusion is the excess amount of fluid around the lungs. There are many reasons that this may happen, so once the fluid is drained, your physician may continue examining you to see what the cause of it was. Normally, there are only a couple of teaspoons of fluid in this space, which allows the lungs to move normally. Pleural effusions are very common and there are nearly 1 million cases each year.
Pleural Effusion Causes
There are many other health problems that can lead to this excess amount of fluid around the lungs. If you have congestive heart failure, liver disease, kidney disease, or any other reason for fluids to build up in your body and then it would leak into the pleural space. Cancer may be another cause, while it can be from lung cancer; it can be from any other cancer too. Pneumonia and tuberculosis are some illnesses that are known to cause pleural effusion too. A pulmonary embolism in which there is a blockage in an artery in one of your lungs can lead to excess fluid. Lastly, there are a few autoimmune disorders, such as lupus or rheumatoid arthritis, which can also be the cause.
Pleural Effusion Symptoms
You may not notice any symptoms in the beginning. Most symptoms are only around when the pleural effusion becomes medium to large size. If you experience symptoms, you will notice: shortness of breath, chest pain, coughing, or a fever.
Pleural Effusion When to Call a Doctor
If your symptoms become severe and uncontrollable, then you must schedule an appointment to see your pulmonologist immediately. A proper diagnosis, when done in a timely manner, may make all of the different when you are on the path to recovery.
Pleural Effusion Diagnosis
Your physician will begin the diagnosis by completing a physical exam and will discuss your symptoms with you. A chest x-ray will be able to confirm the presence of a pleural effusion. On an x-ray, the pleural effusion will appear white and the air will be black. If your physician is not able to see a complete picture with an x-ray, then your physician will recommend a computerized tomography (CT) scan. A CT scan will show multiple x-rays put together so that the physician can see a complete picture of your chest. An ultrasound will create images of your body and they will be displayed on the video screen. A thoracentesis may be done to extract a big of fluid from the lungs for testing
Types of Pleural Effusions
There are two types of pleural effusions. A transudative pleural effusion occurs when the fluid that is a part of the pleural effusion is the same type of fluid that is usually found in this space. This type does not typically need to be drained. An example of this is congestive heart failure.
On the other hand, an exudative pleural effusion contains extra liquids from proteins, blood, bacteria, or inflammatory cells. You will typically need to have this type drained. An example of this type is lung cancer or pneumonia.
Pleural Effusion Treatment
Once there is a confirmed diagnosis and the reason behind the pleural effusion is evident, then your pulmonologist will likely only need to treat the symptoms. For example, if the reason behind the pleural effusion is pneumonia, then your physician will give you medications to treat that first. Large or infected pleural effusions will need to be drained in an effort to feel better and reduce the risk of more health problems in the future. If the effusion is large, then your physician will take more fluid than necessary to test and also to ease symptoms. A chest tube will be in your chest for several days. If your pleural effusion just is not getting better, then your physician will place a long-term catheter to constantly drain. Pleurodesis is when your doctor will inject an irritating substance through the chest tube into the pleural effusion. This will make the chest wall and pleura inflamed and in many cases, the pleural effusion will not come back. Lastly, surgeons may operate inside the pleural space and will remove the dangerous bacteria that are causing the pleural effusion.
Pleural Effusion Risks
There are many risks with treating a pleural effusion. Some cases may be managed with medication alone and are very safe. Most people will recover from this within a couple of weeks. When you have to have surgery to correct this, then you will have more problems. Some problems include pain, or discomfort. If you have severe complications from the surgery then you have pulmonary edema, or fluid in the lungs, a partially collapsed lung, infections, or bleeding. These serious complications are very rare, but in some instances they do occur.
Pleural effusions can be serious and even life threatening in some cases. Most of the time, you will be hospitalized and surgery may be necessary. The time that it will take to recover can be dependent on the size, severity, cause, and your overall health. You will have to stay in the hospital overnight, but you will feel back to normal, on average, between 2-4 weeks.
Pleural Effusion Prevention
While there is no way to truly prevent pleural effusions, there are small steps that you are able to take to reduce the chances of getting sick. You will want to be vaccinated to prevent yourself from getting something such as the flu or pneumonia. Proper hand sanitation and hygiene is also important. Avoid going out in public if there is a strain of sickness going around, especially if you have not been vaccinated or if you have recently been vaccinated. If you are a smoker, then you will need to quit immediately. When you quit smoking, you are reducing your risk of lung cancer or any other type of irritation to the lungs. If you need help to quit smoking, you can speak with your pulmonologist about this. Your physician will have plenty of resources to help you quit. You may also want to find someone that will hold you accountable and may understand what you are going through.