Pleural Effusion

Outline of man's neck and chest showing fluid buildup under right lung.
Pleural effusion is fluid buildup between the layers of tissue that line the outside of the lungs.

Your healthcare provider has told you that you have pleural effusion. Pleural effusion means that you have extra fluid between the pleura. This area is called the pleural space. The pleura are 2 layers of thin, smooth tissue that surround the lungs and line the chest. The pleural space usually holds only a small amount of fluid. This fluid lubricates the pleura. But if too much fluid fills the space, it can make it hard or painful to breathe.

There are 2 types of pleural effusion:

  • Inflammatory. This is caused by a lung disease like pneumonia or lung cancer, both of which irritates the pleura.

  • Noninflammatory. This is caused by abnormal fluid pressures inside the lungs. The pressure can be caused by congestive heart failure (CHF). In CHF, extra fluid collects inside the lung tissues because of a weak heart muscle. This extra fluid then leaks into the pleural space. Other causes of noninflammatory pleural effusions include kidney disease, liver disease, and malnutrition.

What are the symptoms of pleural effusion?

The symptoms of pleural effusion include:

  • Sharp pains in the chest, especially when taking a breath, coughing, or sneezing

  • Trouble breathing

  • Cough

  • Fever

What are the causes of pleural effusion?

Common causes include:

  • Congestive heart failure

  • Cirrhosis of the liver

  • Pneumonia

  • Viral lung infection

  • Cancer

  • Blood clot in the lung (pulmonary embolism)

  • Heart surgery

Chest infections like pneumonia and heart disease are the most common causes. Liver disease (cirrhosis) with ascites also causes pleural effusion. Less common causes include lung cancer.

How is pleural effusion diagnosed?

Your healthcare provider will examine you and ask about your health history. Tests include:

  • Blood tests

  • Analysis of fluid in pleural space, chest X-ray, CT scan, or ultrasound

How is pleural effusion treated?

The extra fluid may be drained from the pleural space. This is done with a procedure called thoracentesis. This procedure uses a thin needle to draw out the fluid from the pleural space. In some cases, a tube is placed in the chest to drain the extra fluid. The tube will likely stay in place for several days.

You may have other treatments, depending on the cause of your pleural effusion. If it’s because of a bacterial infection, you will be given antibiotics to fight the infection. If it’s because of a heart condition, you will be given medicines and other treatment for your heart. Your healthcare provider can tell you more about the cause of your pleural effusion and your treatment choices.

What are the long-term concerns?

If untreated, pleural effusion can lead to serious health problems, such as collapsed lung from fluid filling the pleural space.

Call 911

Call 911 if you have:

  • Trouble breathing

  • Worsening chest pain

When to call your healthcare provider 

Call your healthcare provider right away if you have:

  • Continued coughing

  • Fever of 100.4°F (38.0°C) or as directed by your provider

  • New or worsening symptoms

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