Pleural effusion: Insights and management

Written in association with: Dr Gary Davies
Published:
Edited by: Kate Forristal

Pleural effusion is a condition that can affect individuals, causing discomfort and potential complications. In his latest online article, Dr Gary Davies explains this condition clearly and helps patients navigate their understanding and management of it.

What is Pleural Effusion?

Pleural effusion occurs when excess fluid builds up in the pleural space, a thin layer of fluid that surrounds the lungs and helps them expand during breathing. Normally, there is a small amount of fluid present to lubricate the surfaces of the lungs and chest cavity. However, when this fluid accumulates excessively, it can put pressure on the lungs, making it difficult to breathe comfortably.

 

Causes of Pleural Effusion

There are various reasons why pleural effusion may develop:

  • Congestive heart failure: When the heart struggles to pump blood effectively, fluid can back up into the lungs and accumulate in the pleural space.

 

  • Infections: Pneumonia or other infections can cause inflammation of the pleura, leading to fluid accumulation.

 

  • Liver disease: Conditions like cirrhosis can cause fluid retention and subsequent pleural effusion.

 

  • Cancer: Tumours can spread to the pleura or lungs, leading to fluid buildup.

 

Symptoms 

The symptoms of pleural effusion may differ based on both the quantity of fluid accumulated and the root cause of the condition. Common symptoms include:

  • Shortness of breath, especially when lying down 
  • Chest pain that increases when taking deep breaths or coughing
  • Dry, non-productive cough
  • Fever and chills (if caused by infection)

 

If you experience any of these symptoms, especially if they are persistent or worsening, it is important to seek medical attention promptly.

 

Diagnosis and treatment

To diagnose pleural effusion, your doctor may perform a physical examination, listen to your lungs with a stethoscope, and order imaging tests such as chest X-rays or ultrasound. In some cases, a small amount of fluid may be removed from the pleural space using a procedure called thoracentesis for analysis.

 

Treatment depends on the underlying cause of the effusion:

  • Medications: Diuretics (water pills) may be prescribed to help reduce fluid buildup, especially if heart failure is the cause.

 

  • Antibiotics: If an infection is responsible, antibiotics will be necessary to treat the underlying infection.

 

  • Drainage: In more severe cases or if the effusion is causing significant breathing difficulties, your doctor may drain the fluid using a small tube placed into the pleural space.

 

Dr Gary Davies is an esteemed pulmonologist. You can schedule an appointment with Dr Davies on his Top Doctors profile.

By Dr Gary Davies
Pulmonology & respiratory medicine

Dr Gary Davies is a leading consultant respiratory physician based in central London. He specialises in pleural effusion, obstructive sleep apnoea and fit to fly assessments, alongside aviation medicine, asthma and chronic cough. He privately practices at the Chelsea & Westminster Hospital Private Department, his NHS base is the Chelsea and Westminster Hospital NHS Foundation Trust, where he is the Hospital Medical Director. 

Dr Davies is highly qualified with an MB BS from the University of London, an MD in Aviation Medicine from Imperial College London and an FRCP from the Royal College of Physicians. He investigated the pressure breathing system of the Typhoon (Eurofighter) at the National Heart and Lung Institute and RAF Centre of Aviation Medicine. Dr Davies also undertook a senior fellowship in Respiratory and Intensive Care at The Alfred Hospital in Melbourne, Australia. 

Furthermore he runs a specialist aviation medicine respiratory service, a pleural service and general respiratory clinic at Chelsea and Westminster Hospital. 

Previously, Dr Davies spent over 20 years in the RAF where he was involved in multiple overseas deployments, numerous aeromedical evacuations as well as leading specialist aircrew respiratory and medical clinics. During this time he was the RAF Consultant Advisor in Medicine.
 
Dr Davies' work has been published in various peer-reviewed journals and he's a member of several professional organisations. These include the Society of Acute Medicine, the British Thoracic Society and the American Thoracic Society. He's also a fellow of the Royal College of Physicians (Edinburgh).  

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