Pleural effusion
Pleural effusion is a condition where excess fluid builds up in the pleural space around the lungs, often causing symptoms like shortness of breath, chest pain and persistent cough.
The London Clinic Lung Centre offers comprehensive care for pleural effusion. From accurate diagnostics to personalised treatment, our expert team provides dedicated support from the moment you get in touch.
What is pleural effusion?
Pleural effusion refers to the excessive build-up of fluid between the layers of the pleura (the thin membranes that line your lungs) and the outside of your lungs. While everybody has some fluid in their pleural space, as it helps keep the lungs lubricated and facilitates expansion during breathing, pleural effusion occurs when too much fluid accumulates.
This excess fluid develops when the body produces more than it can absorb, which can affect one or both sides of your chest.
There are two types of pleural effusion: transudative and exudative.
- Transudative pleural effusion typically results from conditions like heart failure or cirrhosis of the liver, where increased pressure in the blood vessels leads to fluid leakage into the pleural space
- Exudative pleural effusion often develops due to cancer or an infection, when the blood vessels or lymphatic system struggle to drain enough fluid
Pleural effusion is relatively common and treatable, though it can sometimes recur and may require further intervention. Early detection is also important, as it can make treatment more effective.
Pleural effusion symptoms
Some people with pleural effusion do not experience any symptoms and may only become aware they have the condition when it’s detected during testing for another health issue.
If you do experience symptoms of pleural effusion, they may include:
- Shortness of breath
- Chest pain
- A persistent cough
- Fatigue
- Orthopnea (difficulty breathing unless sitting or standing upright)
Pleural effusion diagnosis
To diagnose pleural effusion, our specialist team will first evaluate your symptoms and perform a physical examination to check your breathing.
Next, we may advise imaging scans to thoroughly assess your lungs and check for fluid build-up.
Imaging tests to confirm pleural effusion can include:
- Chest X-ray – this is used to confirm the presence of fluid around your lungs
- Ultrasound – provides a detailed view of your lungs and can also guide the needle during a procedure called thoracentesis (which is used to drain extra fluid from around the lungs)
- Computed tomography (CT) scan – this helps identify the underlying cause of pleural effusion, such as infections or other abnormalities
Another type of test to confirm or rule out pleural effusion is thoracentesis. This is where a needle is carefully inserted between your ribs and into your lungs to sample the fluid from the pleural space.
We then analyse the fluid for high levels of protein and other markers that may suggest pleural effusion and determine the type.
What causes pleural effusion?
There are many potential causes of pleural effusion, with some people having more than one underlying factor. Once we determine which type of pleural effusion you have, we can usually identify the specific cause.
The most common causes of pleural effusion include:
- Heart failure – this is the most common cause of transudative pleural effusion, typically due to increased pressure in the blood vessels
- Infection – conditions like pneumonia can lead to exudative pleural effusion due to the inflammation they cause
- Cancer – if cancer cells spread between the pleural layers in your lungs, it can prompt your body to produce excessive fluid, leading to pleural effusion
- Pulmonary embolism – a blood clot that blocks blood flow to the pulmonary arteries, potentially leading to fluid build-up around the lungs
- Kidney or liver disease – these conditions can cause fluid to accumulate in the abdomen, which may then leak into the pleural space around the lungs
- Autoimmune disorders – inflammation caused by these disorders can affect the pleura, increasing the risk of fluid leaking into the pleural space
- Open-heart surgery – inflammation and diaphragm dysfunction caused by surgery can increase the risk of pleural effusion
Pleural effusion treatment
At The London Clinic Lung Centre, we offer personalised treatments for pleural effusion, tailored to your unique needs. Using the results from your investigations, we will create the right treatment plan for you.
We aim to treat the underlying cause of your pleural effusion to ensure we keep the risk of it returning to a minimum. This may involve addressing conditions such as heart failure, infections or cancer.
Additionally, thoracentesis can be used as a treatment to drain excess fluid and alleviate symptoms like breathlessness.
Other treatments can involve:
- Pleurodesis – a procedure that seals the space between your lungs and chest wall to prevent further fluid build-up
- Indwelling pleural catheter – a long-term drainage solution for pleural effusion, where a thin, flexible tube is inserted into your chest and connected to a drainage bottle to remove excess fluid
- Video-assisted thoracoscopic surgery (VATS) – a minimally invasive procedure that uses a small, thin camera to see inside your lungs and perform keyhole surgery to remove fluid build-up
We will carefully discuss your treatment options with you based on your type of pleural effusion and its underlying cause, ensuring that we provide you with dedicated care.
Frequently asked questions (FAQs)
While it is not always possible to prevent pleural effusion from occurring, you can reduce your risk by managing underlying conditions that increase the likelihood of it developing. Seeking early treatment can also keep your risk of pleural effusion down.
Pleural effusion is usually treatable, but it may not always be fully curable. It is important to note that pleural effusion can sometimes recur, especially if the underlying cause isn’t addressed.
The main difference between pulmonary oedema and pleural effusion is where the fluid accumulates. In pulmonary oedema, fluid builds up in the lungs, whereas in pleural effusion, fluid collects in the pleural space around the lungs.