Pleural effusion: symptoms, causes, to treatment

Definition

What is a pleural effusion?

Pleural effusion is a condition where there is a buildup of fluid in the pleura, which is the cavity that lies between the lungs and the chest wall. This condition is generally caused by other illnesses that the patient has, such as congestive heart failure, pneumonia, and pulmonary embolism.

In normal circumstances, there is a small amount of fluid in the pleura which functions as a lubricant, so that the lungs can move smoothly and breathing becomes smooth.

If there is excess fluid in the pleura, it can put pressure on the lungs and cause difficulty breathing.

Broadly speaking, pleural effusions can be classified into two, namely transudates (caused by leaking blood vessels) and exudates (fluid derived from inflammation of the pleura and lungs). This condition can also occur in one lung (unilateral) and both sides of the lung (bilateral).

How common is this condition?

Pleural effusion is a very common health condition, with an estimated 1 million cases diagnosed each year. Sufferers also come from any age group. This condition is generally more common in women than men.

Pleural effusion is a very serious case and can cause death if not treated immediately. Journal of Pulmonary & Respiratory Medicine stated that as many as 15% of patients diagnosed with pleural effusion died within 30 days.

Symptoms and Causes

What are the symptoms and causes of pleural effusion?

Pleural effusion symptoms usually vary depending on what is the underlying cause. There are times when the buildup of fluid in the pleura is not always associated with lung problems.

Common symptoms of pleural effusions include the following:

• Chest pain
• Dry cough
• Fever
• Frequent hiccups
• Difficulty breathing when lying down
• Hard to breathe

When should I see a doctor?

Pleural effusion symptoms that need to be treated as soon as possible are chest pain and difficulty breathing.

However, if you are worried about other symptoms you are feeling, immediately consult a doctor or medical professional closest to you.

It is important to know that each person's body is different and of course will show varying symptoms as well. Always consult a doctor to get the most appropriate treatment for your health condition.

Cause

What causes pleural effusion?

As previously described, pleural effusions are of two types, namely transudates and exudates. Both are divided based on which organs cause them.

Quoted from the Cleveland Clinic, here are the diseases that most often cause fluid buildup in the pleura and their symptoms:

1. Transudate pleural effusion

A buildup of fluid that is categorized as a transudate is caused by fluid leaking out of the blood vessels into the cavity in the pleura.

The fluid found in transudate pleural effusions contains lower levels of protein and lactic acid than the exudate type.

The following are diseases that may cause transudate pleural effusions:

Congestive heart failure

Congestive heart failure (CHF) or congestive heart failure is a condition in which the heart cannot pump enough blood around the body. This can interfere with the formation and absorption of fluid in the pleura.

The symptoms of pleural effusion due to congestive heart failure are coughing, shortness of breath, easy fatigue, and swelling.

Cirrhosis of the liver

Cirrhosis of the liver can also lead to a buildup of fluid in the pleura. This condition is also called hepatic hydrothorax .

The signs that will arise are usually coughing, hypoxia (lack of oxygen), chest pain, feeling unwell (malaise), fatigue, and fever.

Nephrotic syndrome

This condition occurs when the kidneys excrete too much protein in body fluids. This can affect kidney function and fluid levels in the pleura.

Symptoms exhibited by this disease are edema (swelling) in the eyes and feet, foamy urine, loss of appetite, and fatigue.

2. Exudate pleural effusion

Exudate pleural effusion is caused by inflammation that occurs in the pleura. This type occurs because of problems with the lungs, such as:

Pneumonia

Pneumonia is an infection that affects one or both parts of the lungs. This condition can cause fluid to collect in the pleura.

Pleural symptoms associated with pneumonia are chest pain when coughing or breathing, fatigue, confusion, nausea, fever, body chills, and difficulty breathing.

Lymphoma

Lymphoma is cancer that attacks the body's lymphatic system, such as the lymph nodes, spleen and spinal cord. Cancer cells can affect the flow and production of fluid in the pleura.

This disease can show symptoms such as shortness of breath, chest pain, pressure in the chest, and pain when lying down.

Pulmonary embolism

Pulmonary embolism is one of the most common causes of pleural effusion. It is triggered by increased interstitial fluid in the lungs as a result of ischemia or the release of vasoactive cytokines.

Symptoms that are commonly felt are chest pain, shortness of breath, chest tightness, coughing, and fever.

Lung cancer

Similar to lymphoma, cancer cells that attack the lungs can result in fatal fluid production in the pleura.

Fluid buildup in the pleura due to lung cancer can produce symptoms such as fever, malaise, and a feeling of heaviness or pressure in the chest.

Tuberculosis (TB)

TB disease can cause symptoms of pleural effusion, such as night sweats, coughing up blood, and losing weight.

Other diseases that can cause pleural effusions include:

• Rheumatoid arthritis
• Meigs Syndrome
• Systemic lupus erythematosus
• Uremia

There may be causes, signs, and symptoms not listed above. If you have concerns about a particular symptom, consult your doctor.

Risk factors

What increases my risk of developing this condition?

Pleural effusion is a medical condition that can happen to anyone. However, there are many factors that increase the risk of developing this disease, from health, lifestyle, to drugs that have been consumed.

Risk factors that can trigger pleural effusions are:

• Actively smoking
• Drinking alcoholic beverages
• Have suffered from any of the aforementioned diseases or medical conditions
• Have had high blood pressure
• You are female
• Have had a peritoneal dialysis procedure on the kidneys
• Having cancer treatments or treatments that affect how the body retains fluids.

Diagnosis

How is this condition diagnosed?

Generally, pleural effusions can be seen from a doctor's examination. The doctor will ask about your medical history and symptoms.

After that, the doctor will usually perform a physical examination using a stethoscope or tapping your chest.

Pleural effusion reduces the air that enters the lungs. If during the examination the doctor can hear a squealing or grinding sound, it is likely that the pleura in the lungs has filled with fluid.

Some other tests may also be done by the doctor to find out how much fluid is accumulating in the lungs, such as:

1. X-ray test

This test is usually done to see if there is fluid in the pleura. If there is, the doctor will direct the patient to lie on his side, depending on which part of the body contains more fluid.

2. Tests ultrasound (Ultrasound)

An ultrasound test is also done to see if the fluid in the pleura is flowing or is just gathering at one point.

3. CT scan

Not only to get a clearer picture of the location of the fluid, the CT scan test also aims to find out other causes of effusion.

4. Thoracentesis

A procedure called pleural fluid analysis or thoracentesis is to insert a thin needle into the pleural membrane and take a sample of the fluid for further examination.

This procedure can show whether the fluid buildup in the pleura is caused by an infection or other condition. The fluid sample will also be tested for cancer cells and protein levels.

The doctor will perform a chemical analysis to distinguish the type of effusion, whether it is a transudate or an exudate type. Usually, the two can be distinguished by measuring the protein level in the fluid and comparing it to the protein level in the blood.

Exudate pleural effusions contain higher protein than transudates.

In addition to protein, the doctor will also check levels lactate dehydrogenase (LDH) or lactic acid contained in fluids.

The doctor may also analyze with a complete blood count procedure (complete blood cell count) to determine the presence of tumor cells or infection.

Based on the results of the above diagnosis, the doctor can determine what kind of treatment is suitable for your condition. However, there are times when further tests are needed.

Medicines & Medicines

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

How is pleural effusion treated?

Pleural effusion treatment depends on the symptoms and causes experienced by the patient. In cases of effusion caused by diseases such as pneumonia and heart failure, the doctor will prescribe several types of drugs.

Often times there is no need for special treatment for fluid buildup, because the liquid will disappear on its own when the cause has been resolved. However, if the effusion has severe infection and inflammation, a surgical procedure will be performed to drain the fluid and prevent complications.

Here are some treatments that doctors give to treat pleural effusions:

1. Treat the causes of pleural effusion

Pleural effusions can be caused by various types of diseases. That is why, doctors will try to solve the cause. Some of the treatments given include:

• Taking antibiotics: Antibiotics will usually be prescribed by a doctor if the condition is caused by a disease, such as pneumonia and empyema.

• Chemotherapy or radiotherapy: If the buildup of fluid in the pleura is caused by diseases, such as lung cancer and lymphoma, the doctor will perform chemotherapy and radiotherapy procedures to reduce cancer cells.

• Diuretic drugs: Diuretic drugs are usually given if the patient has heart-related diseases, such as congestive heart failure.

2. Overcoming pleural effusion directly

If the treatment to treat the causes of the effusion does not show significant changes and the pleural condition is getting worse, the doctor will recommend actions that are directed at the buildup of fluid, such as a surgical procedure.

Some of them are:

• Pleurodesis: A special fluid will be injected into the membrane area and cause mild inflammation. This helps prevent the buildup of fluid from building up. The chemicals that are often injected are tetracycline, sterile talc and bleomycin. Pleurodesis is most often used in the treatment of recurrent effusions caused by cancer.

• Drainage installation: Installing a drainage permanently is another way to help drain fluid in the pleura. Once fluid builds up, drainage can immediately drain it from the chest cavity.

• Installation shunt: Similar to a drainage, this procedure aims to remove fluid from the chest into the abdominal cavity.

• Pleurectomy: If all of the above procedures have been performed but do not show success, surgical removal of the pleura will be recommended.

Home remedies

What are some lifestyle changes or home remedies that can be done to treat pleural effusions?

Here are lifestyle and home remedies that can help you deal with pleural effusions:

1. Stop smoking

If you actively smoke, quit as soon as possible. The toxic substances and substances in cigarettes can only make the pleural effusion symptoms worse. This method can also help you maintain lung health in general.

2. Avoid alcoholic drinks

Alcohol can affect liver function. If your liver is damaged, you may be at risk for the condition hepatic hydrothorax which affects the buildup of fluid in the pleura.

Reducing, even quitting alcohol altogether, is the best action and prevention so that pleural effusion symptoms do not appear again.

3. Not doing strenuous activities

If you are positive for fluid buildup in the pleura, you should avoid activities that are too extreme, such as strenuous exercise and lifting excess weights.

4. Get enough rest

By taking enough time to rest between your busy schedule, you reduce the chances of developing pleural effusion symptoms at the next time.

5. Eat a healthy diet

Replacing your daily diet with nutritious ingredients such as vegetables and fruits will provide significant changes to lung health, especially the pleura.

6. Consultation with a doctor

If you are undergoing cancer treatments such as chemotherapy and radioactivity, or you are taking certain drugs, talk to your doctor about possible side effects and ways to overcome them.

If you have any questions, consult your doctor for the best solution to your problem.