Pleural fluid develops in small amounts to lubricate the surfaces of the pleura, the thin tissue that lines the chest cavity and surrounds the lungs. When a pleural effusion is present, an abnormal, excessive collection of this fluid builds up and can affect breathing. This can be caused by congestive heart failure or by mesothelioma. As the fluid builds up it can cause inflammation irritation and swelling to occur in the pleura.
Symptoms
Symptoms include chest pain, which usually develops along with a cough or deep breaths, fever, hiccups, rapid breathing and/or shortness of breath. Pleural effusions are difficult to diagnose because sometimes there are no symptoms at all. In these cases, pleural effusions are usually only discovered when another condition is suspected, and performs diagnostic testing, such as a chest x-ray or thoracic CT scan.
The following tests may help to confirm a diagnosis:
* Chest x-ray
* Pleural fluid analysis (examining the fluid under a microscope to look for bacteria, amount of protein, and presence of cancerous cells)
* Thoracentesis (a sample of fluid is removed with a needle inserted between the ribs)
* Thoracic CT
* Ultrasound of the chest
Treatment
A medical professional may recommend a form of treatment to alleviate the fluid build-up or remove it, depending on each case, or addressing the underlying cause of the fluid buildup.
Therapeutic thoracentesis may be done if the fluid collection is large and causing pressure, shortness of breath, or other breathing problems, such as low oxygen levels. Removing the fluid allows the lung to expand, making it easier for the patient to breathe.
Pleural effusions caused by infection are treated with appropriate antibiotics. In people with cancer or infections, the effusion is often treated by using a chest tube for several days to drain the fluid. Chemotherapy, radiation therapy, surgery, or instilling medication into the chest that prevents re-accumulation of fluid after drainage may be used in some cases.
The expected outcome depends upon the underlying disease.
