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General Practice 2023

Pleural effusion: what é, why it happens, symptoms and treatment

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Pleural effusion: what é, why it happens, symptoms and treatment
Pleural effusion: what é, why it happens, symptoms and treatment
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Pleural effusion occurs due to excessive accumulation of fluid in the pleural space, which is the space created between the lung and the outer membrane that covers it, and may occur due to cardiovascular, respiratory or autoimmune problems, such as Lupus, for example.

This accumulation makes it difficult for the lungs to work normally and, therefore, breathing can be seriously affected, and treatment should be carried out as soon as possible in the hospital to remove excess fluid.

How does pleural effusion happen

In normal situations, the amount of fluid in the pleural space is very small, about 10 mL, and results from a perfect balance between its production and absorption.However, when there is a he alth problem such as lung infections or heart failure, this balance can be affected, leading to excessive accumulation of fluid.

Since the liquid cannot be absorbed properly, it slowly accumulates, increasing pressure on the lung, which makes breathing difficult, leading to symptoms such as chest pain and shortness of breath, for example.

What can cause a stroke

The main causes of pleural effusion are related to inflammation of lung or pleural tissues, and include:

  • Pneumonia;
  • Tuberculosis;
  • Lung cancer;
  • Pulmonary embolism;
  • Rheumatoid arthritis;
  • Lupus.

However, stroke can also be caused by problems that lead to increased fluid throughout the body, such as decompensated heart failure, cirrhosis, or advanced kidney disease.

Learn about other causes of water in the lungs.

How to confirm the spill

X-ray with pleural effusion on the left side

X-ray with pleural effusion on the left side

The best way to confirm the presence of a pleural effusion is to have a chest X-ray to look for fluid accumulation, which is represented by a white area in the lung. In most cases, the cause of pleural effusion is already known, as in the case of heart failure, however, when the effusion appears without an apparent cause, further tests may be necessary to identify the cause and initiate appropriate treatment.

Main symptoms

Early symptoms that may indicate the development of a pleural effusion include:

  • Difficulty breathing;
  • Feeling short of breath;
  • Chest pain, worse when taking a deep breath;
  • Persistent cough.

In most cases, these symptoms do not appear in small pleural effusions and even when they do appear they can be associated with their causes, such as heart failure or pneumonia. Therefore, it is always recommended to have an X-ray to evaluate the possibility of a stroke, especially in decompensated cases or when the symptoms are very intense.

How the treatment is done

Pleural effusion is treated when it is very large and causes symptoms such as intense pain or shortness of breath, because when it is small, it can be absorbed by the body, and it is only necessary to do new X-rays to observe its evolution.

In cases where treatment is needed and there is a large volume, the doctor usually performs drainage of the fluid, which is done using a needle and syringe to pass through the chest wall and into the fluid-filled space, removing the excess and taking some of the liquid to be evaluated and discover the cause of the effusion.

Since there is a great risk that the pleural effusion will return a few weeks after being aspirated, it is very important to identify what is causing the problem, initiating the appropriate treatment of the cause.

Physiotherapy for pleural effusion

After the removal of excess fluid, the doctor may recommend that respiratory physiotherapy consists of a set of breathing exercises taught by the physiotherapist that help the lung to return to its normal size, after being pressed by the effusion.

These exercises are important to reduce discomfort when breathing, but also to increase the amount of oxygen in the body. Understand how respiratory physiotherapy is performed.

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