Understanding Pleural Effusion: Symptoms, Causes, Treatment and Types

Pleural Effusion is a condition that affects your lungs. For early diagnosis and effective management of this respiratory disorder, you need to recognise its subtle symptoms. In this informative guide, we will be discussing the symptoms, causes, diagnostic procedures, and options for pleural effusion treatment, that will help you tackle this disorder in the best way possible.

What is pleural effusion?

Pleural effusion is a medical condition characterised by the accumulation of excess fluid in your pleural cavity. It is the space between the layers of your pleura, the thin membranes surrounding your lungs.

Is pleural effusion serious?

Yes, pleural effusion can be a serious medical condition. The severity depends on the underlying cause and the amount of fluid accumulated in your pleural cavity. If left untreated, it may compromise your lung function, leading to severe complications.

What are the symptoms of pleural effusion?

Common symptoms of pleural effusion include:

• Breathlessness is a common symptom of pleural effusion.
• Sharp or dull pain in your chest during deep breaths or coughing.
• Persistent cough that doesn't resolve and may be accompanied by sputum production.
• On examination, doctors may detect decreased breath sounds.
• Feeling unusually tired or weak due to decreased lung efficiency.
• Systemic symptoms of pleural effusion like fever and chills may be present.
• Bluish discoloration of your skin or lips due to oxygen deprivation (Cyanosis).

What causes pleural effusion?

There are several different causes of pleural effusion:

• Bacterial, viral, or fungal infections of the respiratory system are a major cause of pleural effusion. They trigger an inflammatory response that results in fluid accumulation.
• Congestive heart failure increases pressure in the blood vessels surrounding your lungs. This elevated pressure can force fluid into the pleural space, causing effusion.
• Chronic liver disease can be a cause of pleural effusion. The impaired synthesis of proteins, such as albumin, reduces oncotic pressure, allowing fluid to accumulate in your pleural cavity.
• Tumours affecting your lungs, breast, or other adjacent organs can directly invade your pleura or induce pleural effusion through the lymphatic obstruction.
• Blood clots in the pulmonary arteries may cause pleural effusion. The obstruction of blood flow triggers inflammation and fluid leakage into the pleural space.
• Conditions like rheumatoid arthritis and lupus can lead to pleural effusion due to inflammation and immune system dysregulation.

What are the types of pleural effusion?

There are various types of pleural effusion:

• Transudative Pleural Effusion: It involves the leakage of protein-poor fluid into your pleural space.
• Exudative Pleural Effusion: Exudative effusions contain higher levels of proteins and other substances.
• Parapneumonic Effusion: Linked to pneumonia, this type of pleural effusion occurs due to the spread of infection to the pleural space.
• Malignant Pleural Effusion: Resulting from cancer cells invading the pleura, this effusion is often exudative and associated with cancers like lung or breast cancer.
• Haemothorax: Involves the accumulation of blood in your pleural cavity, often due to surgery, or bleeding disorders.
• Chylothorax: A rare type involving the leakage of chyle, a lymphatic fluid, into your pleural space.

How is pleural effusion diagnosed?

A thorough pleural effusion diagnosis involves:

• The doctor assesses your symptoms, and risk factors, and performs a physical examination to detect signs like decreased breath sounds or chest pain.
• Chest X-rays indicate the location and extent of pleural effusion.
• A needle is inserted into your pleural space to collect fluid for analysis (Thoracentesis).
• Blood tests may reveal infection markers, autoimmune factors, or signs of organ dysfunction.
• In cases of suspected malignancy or unclear diagnosis, a tissue sample may be used for examination.
• Thoracoscopy or Pleuroscopy are invasive procedures where a thin tube with a camera is inserted to directly see your pleura and obtain biopsies.

How is pleural effusion treated?

Pleural effusion treatment depends on the type of pleural effusion diagnosed:

• Primary pleural effusion therapy involves antibiotics for infections, diuretics for heart failure, or chemotherapy for cancer-related pleural effusions.
• Draining excess fluid through thoracentesis can relieve symptoms and improve lung function.
• To prevent fluid re-accumulation, medications like talc may be instilled into your pleural space
• A catheter may be placed for long-term drainage, allowing you to manage fluid at home.
• In severe cases, surgery may be necessary to remove your pleura.

Surgery

There are two main surgical processes for pleural effusion treatment:

Video-assisted thoracoscopic surgery (VATS)

In pleural effusion cases, VATS allows for precise examination of your pleural space through small incisions. Surgeons use a thoracoscope to look at and address the underlying causes of pleural effusion. It is particularly beneficial for pleurodesis, a procedure to prevent fluid re-accumulation by inducing pleural adhesion. This minimally invasive pleural effusion treatment reduces recovery time, and postoperative discomfort, and provides an effective therapeutic solution for patients.

Thoracotomy (Also referred to as traditional, “open” thoracic surgery)

It is a traditional approach for pleural effusion treatment where a large incision is made between your ribs, providing direct access to your pleural space. Thoracotomy is used when less invasive methods, like thoracentesis or VATS, may not suffice. It allows for comprehensive exploration, biopsy, and effective drainage of complex pleural effusions.

What are the risk & complications of pleural effusion?

Risks and complications of pleural effusion may involve respiratory distress, potentially leading to hypoxia and respiratory failure. Untreated or recurrent effusions may result in pleural thickening and fibrosis, impairing your lung function. If pleural effusion is caused as a result of pneumonia, infections can occur. In severe cases, pleural effusion may indicate underlying serious conditions like cancer or heart failure.

What’s the outlook for pleural effusion?

The outlook for pleural effusion depends on its underlying cause. With targeted treatment addressing the root issue, many individuals experience successful resolution and improved lung function. However, chronic pleural effusions may require continuous management.

Conclusion

In a nutshell, pleural effusion is a complex lung disorder that demands immediate medical attention. Whether caused by infections, malignancies, or other factors, early diagnosis and appropriate management significantly impact its prognosis. Advances in techniques, such as VATS, offer minimally invasive options. Ongoing research continues to enhance our approach, underscoring the importance of a personalised strategy in addressing pleural effusion.

Are you experiencing respiratory symptoms that are suggestive of pleural effusion? Get yourself tested today at Metropolis Labs. We specialise in offering comprehensive blood tests for pleural effusion that ensure you receive accurate insights. Book your test today.