Pleural Effusion

Pleural Effusion General Information

Pleural Effusion is a disease characterized by an accumulation of fluid in the pleural space, the space between the two layers of pleura. Some doctors diagnose the disease under the name of water on the lungs. The most common signs and symptoms caused by this kind of disease can appear as shortness of breath, chest pain, gastric discomfort or dyspepsia and cough. Generally, into the patient’s chest there are two thin membranes, one in the lining of the lungs called visceral pleura, and one that covers the inside of the patient’s chest wall called parietal pleura. In normal cases, small vessels, that are present in these layers, secrete a small amount of fluid that helps the membranes to glide during breathing. When the amount of fluid increases, a part of it is taken by the lymph vessels, maintaining a balance. If the amount of fluid increases so high that it prevents it removal by the lymph vessels, it builds up leading to the appearance of Pleural Effusion. There are cases in which the condition can appear as a sign of another more severe disease.

There are two types of Pleural Effusion and can include the transudate and the exudate. It is very important to know that these types are very different, especially considering the fluid and what part of the lung is affected. A transudate is a clear fluid, which is usually caused by the imbalance of the forces that help producing and removing the fluid between the two pleura.

Pleural Effusion Symptoms

Each type of Pleural Effusion is caused by different factors. The transudative type of the disease can be caused by congestive heart failure, which usually affects both sides of the patient’s chest. In most cases, if the both sides of the chest are affected, the condition can cause severe complications such as heart failure which can lead to the death of the patient. There are also cases in which it affects only one side of the chest and it is called pericarditis, considered an inflammation of the pericardium, the membrane that normally covers the patient’s heart. Large amounts of fluid in the patient’s body tissues can reach the pleural space. In most cases Pleural Effusion appears when the patient suffers from kidney diseases or if he has bowel disorders and absorbs only a small amount of what he eats, if he takes intravenously fluids or if he has liver diseases (that is why almost half of the patients suffer from cirrhosis).

The exudative type of the disease can be caused by the following risk factors: pleural tumors, tuberculosis in the lungs, pneumonia, and certain infections caused by a virus, fungi or parasite, blood clots into the patient’s lungs, connective tissue diseases such as rheumatoid arthritis or lupus, pancreas disorders, and injuries of the chest. The most common signs and symptoms caused by Pleural Effusion can include shortness of the breath, pain in the chest, and dry cough. There are cases in which the disease can be asymptomatic (it does not present obvious manifestations).

Pleural Effusion Treatment

In most cases, to diagnose this lung disorder - Pleural Effusion and for an exact determination, doctors perform an X-ray of the patient’s chest. On the X-ray image the doctor can observe that the fluid is present on the bottom of the patient’s lungs hiding the normal lung structure. There are cases in which the disease can cause heart failure and the image of the X-ray can show the heart as an enlarged shadow. Some doctors, due to medical reasons, apply other procedures to diagnose the disease and can include ultrasound scan which can disclose a small effusion that can be considered abnormal. In more severe cases, when the disease has reached an increased stage, doctors can perform a computed tomography scan which can help determining if the lungs have also been affected.  Usually, there are certain procedures that can help the doctor to determine the exact type of Pleural Effusion the patient is suffering from. To diagnose the transudate type of this medical condition the doctors apply the thoracentesis operation which consists in inserting a needle or a catheter into the pleural space to obtain a fluid sample, which is eventually examined for cells and possible viruses or bacteria. Usually, culturing the fluid sample can help determine the bacteria that caused tuberculosis or other diseases that can cause Pleural Effusion.

If the patient’s disease is considered severe or it has progressed to an advanced stage, doctors take a tissue sample using pleural biopsy and examine it under a microscope. There are cases in which the disease is caused by a lung disorder and with the help of a bronchoscope (a tube that is placed into the airways); doctors can examine any unusual appearance of the patient’s lungs. Generally, the best way to treat this kind of medical condition is to focus the treatment on the underlying cause of it, rather than treating the disease itself. Even after many intensive tests and examination the cause of the disease remains unknown, the first treatment option is to drain the fluid away using the same tube that can be used during thoracentesis. To control the amounts of fluid into the pleural space the procedure can be done several times. There are cases in which severe forms of Pleural Effusion can recur and the first treatment option when this happens is injecting a drug or a material that irritates the pleural membranes causing them to become inflamed. By doing this the inflammation causes them to adhere close together, a process also known as sclerosis. This will prevent any future recurrence by eliminating the fluid from the pleural space. It is very important to treat Pleural Effusion in the first stages of development to prevent any future, more severe, complications that can lead to the death of the individual. Some very efficient medicines used along other therapies as additional treatment and preferred by most of the specialists are: Alodox, Doryx, Oracea, Vibra-Tabs, Vibramycin Monohydrate, Vibramycin Calcium, Periostat, Oraxyl, Monodox, Adoxa CK Kit and Doxy 200.