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Pleural Effusion

Last updated Dec. 17, 2018

Approved by: Maulik P. Purohit MD, MPH


Pleural Effusion is the accumulation of fluid within the pleural space. The pleura are a protective bi-layer. One layer lines the lung, while the other lines the chest wall. The space between these two layers is referred to as the pleural cavity or pleural space.

What are the other Names for this Condition? (Also known as/Synonyms)

  • Fluid in Pleural Cavity

What is Pleural Effusion? (Definition/Background Information)

  • Pleural Effusion is the accumulation of fluid within the pleural space
  • The pleura are a protective bi-layer. One layer lines the lung, while the other lines the chest wall. The space between these two layers is referred to as the pleural cavity or pleural space
  • This space normally contains small amounts of fluid, which allows it to slide easily as one inhales and exhales air. When there is a buildup of fluid in this area, it becomes harmful to the lung and is termed Pleural Effusion
  • There are different forms of fluids that can accumulate in the pleural cavity, which could include fluid (pleural fluid), blood (hemothorax), or pus (empyema). The condition is typically observed in individuals with some pre-existing lung conditions such as an injury, tumor, or infection
  • Pleural Effusion may result in chest pain, abnormal breathing, cough and fever. in case of complications, empyema and pneumothorax, may be seen
  • The main goal of treatment for Pleural Effusion is to provide relief to the patient and to treat the underlying cause, once it is diagnosed. Generally, the outcome depends on the underlying lung condition

Who gets Pleural Effusion? (Age and Sex Distribution)

  • Pleural Effusion is more commonly seen in patients who have some pre-existing lung conditions
  • It can affect both male and female genders of any age
  • Pleural Effusion is seen worldwide; all racial and ethnic groups are affected

What are the Risk Factors for Pleural Effusion? (Predisposing Factors)

Common risk factors associated with Pleural Effusion include:

  • Pre-existing lung damage or disease
  • Chronic smokers
  • Lung cancer patients, individuals with any other type of lung tumor
  • Having occupational exposure to asbestos
  • Liver cirrhosis
  • Heart failure

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Pleural Effusion? (Etiology)

There are two types of Pleural Effusion. These are termed transudative and exudative.

  • Transudative Pleural Effusion occurs when fluid seeps into the pleural space
  • Common causes of this type are:
    • Congestive heart failure
    • Liver cirrhosis             
  • Exudative Pleural Effusion occurs because of a blockage in the blood vessel or lymph vessel
  • Common causes of this type are:
    • Lung tumors
    • Lung infection/inflammation caused by conditions such as tuberculosis, rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE)
    • Adverse drug reaction
    • An injury to the lungs

What are the Signs and Symptoms of Pleural Effusion?

The most common signs and symptom of Pleural Effusion are:

  • Chest pain
  • Breathing problems, such as rapid breathing and shortness of breath
  • Fever and cough, if caused by an infection
  • Hiccups

How is Pleural Effusion Diagnosed?

The diagnosis of Pleural Effusion may include:

  • Complete evaluation of medical history along with a thorough physical exam
  • The main focus of the physical examination will be on the chest region; the physician will listen for abnormal sounds with a stethoscope

Other diagnostic test procedures may include:

  • Imaging studies such as chest X-ray and CT scan of the chest
  • Thoracentesis: It is a minimally-invasive procedure in which a needle is placed between the ribs to obtain a sample of the fluid present within the region. The sample fluid is then sent to the laboratory for further analysis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Pleural Effusion?

Possible complications of Pleural Effusion include:

  • Empyema: It is an accumulation of pus within the pleural space
  • Pneumothorax: Presence of air in the pleural space, which requires urgent attention by a healthcare provider

How is Pleural Effusion Treated?

The main goal of treatment for Pleural Effusion is to help the individual feel better and to determine and treat the underlying cause.

  • The best method is to remove the fluid, which is found within the pleural space, by a procedure called thoracentesis. It is also known as pleural fluid aspiration or a pleural tap
  • In some cases, the fluid keeps accumulating despite being drained periodically, which is called Recurrent Pleural Effusion. In such resistant cases, chemotherapy medications may also be required to actually seal this space, by a procedure known as pleurodesis. Such medications help the two layers to stick together causing elimination of the pleural space

Surgery may also be done if necessary, when other treatment options have failed.

  • One option is to insert a permanent drain from the pleural cavity to the outside
  • Pleurectomy: In this surgical procedure, a shunt is created between the pleural cavity and the abdominal cavity. This causes the fluid from the pleural cavity to drain into the abdominal cavity. Such a shunt is called a pleuro-peritoneal shunt. This procedure is however, not commonly used

In cases, where there is only a small accumulation of the pleural fluid, and there is no or mild symptoms, treatment is usually not needed. In these cases, close observation is necessary to monitor the individual.

How can Pleural Effusion be Prevented?

  • Preventative measures for Pleural Effusion depend upon the underlying cause
  • Since, there is no single cause for Pleural Effusion; such measures entirely depend upon preventing the causative factors responsible for this chest condition

What is the Prognosis of Pleural Effusion? (Outcomes/Resolutions)

  • The prognosis of Pleural Effusion depends upon the underlying cause
  • If the underlying cause is detected promptly and appropriately managed, the outcome is better

Additional and Relevant Useful Information for Pleural Effusion:

  • A pleural fluid analysis test identifies the makeup of fluid in the pleural layer. In addition to this, the test serves as an excellent opportunity to remove fluid and alleviate pressure in the pleural layer

The following article link will help you understand pleural fluid analysis:


What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: May 27, 2015
Last updated: Dec. 17, 2018