What is pleural effusion?
Pleural effusion occurs when too much fluid builds up in the pleural space, the thin area between the lungs and the wall lining the inside of the chest. Normally, this space contains a small amount of fluid to help the lungs move smoothly during breathing. However, when excess fluid accumulates, it can put pressure on the lungs and make breathing difficult.
Pleural disease care at Penn Medicine includes a dedicated team of specialists with the expertise and passion to treat a wide range of pleural disorders, including pleural effusion.
What are the symptoms of pleural effusion?
The most common symptom of pleural effusion is shortness of breath (dyspnea), caused by fluid buildup pressing on the lungs and making it harder to expand them fully. Many people also experience chest pain, which may feel sharp and worsen with deep breaths or coughing.
Other symptoms can include:
- A dry cough, often due to lung irritation rather than mucus buildup
- Fever and chills, if an infection is present
- Hiccups or rapid breathing
- Difficulty lying flat, as fluid shifts can make breathing harder
In some cases, pleural effusion causes no noticeable symptoms.
What causes pleural effusion?
Pleural effusion often develops due to an underlying health condition. It’s classified into two main types, transudative and exudative, based on what causes the fluid buildup.
Transudative pleural effusion occurs when fluid leaks into the pleural space due to increased pressure in blood vessels or low protein levels in the blood. The most common cause is congestive heart failure, which can lead to fluid buildup when the heart struggles to pump blood effectively. Other conditions, such as cirrhosis and kidney disease, can also contribute by causing fluid retention and imbalance.
Exudative pleural effusion results from inflammation, infection, or blockages in blood or lymph vessels. Pneumonia and other lung infections can trigger this type as inflammation causes fluid to collect around the lungs. Cancer, especially lung cancer or cancer that has spread to the lungs, can also lead to persistent fluid buildup. Other causes include pulmonary embolism (a blood clot in the lungs), autoimmune disorders like lupus or rheumatoid arthritis, and tuberculosis, chest trauma, or recent chest surgery. All of these can create inflammation or disrupt normal fluid drainage.
Diagnosing pleural effusion
Diagnosis begins with a physical exam, where a healthcare provider listens to the lungs and checks for fluid buildup. Imaging tests help confirm the condition. If needed, fluid can be removed for testing to check for infection, cancer, or other underlying causes. Additional blood work and specialized tests may be done to assess heart, liver, or kidney function and identify potential underlying causes.
Treatment for pleural effusion
Treatment usually focuses on addressing the underlying cause and relieving symptoms. If an infection is the cause, antibiotics are used, while diuretics help manage effusions related to heart failure. Minimally invasive procedures can be done to remove excess fluid or insert a chest tube for continuous drainage. To prevent fluid from reaccumulating, a procedure may be performed to seal the pleural space. In severe cases, surgery may be performed to remove thickened pleural tissue that is restricting the lung.
Prevention of pleural effusion
While not all cases of pleural effusion can be prevented, managing underlying conditions can help reduce the risk. Controlling heart failure, treating infections like pneumonia promptly, and managing chronic illnesses such as liver or kidney disease are key steps. Avoiding smoking, alcohol, and environmental toxins like asbestos, maintaining a healthy lifestyle, and staying on top of medical care can also help lower the chances of pleural effusion or its recurrence.
Leading the way in pleural effusion care
Conditions like pleural effusion can be complex and serious, but at Penn Medicine, our highly skilled specialists use the latest technology and years of experience to diagnose and treat them effectively. As a leading research center for pleural diseases, we are actively developing new and innovative treatments.
Our experts have access to the most advanced therapies that are not widely offered elsewhere, including specialized treatments available at Penn Medicine’s Harron Lung Center. With a team of specialists working together, we focus on identifying and treating the underlying cause of your pleural effusion to provide a targeted treatment plan with individualized care that’s right for you.