“Small pleural effusions can be diagnosed by chance, as a result of an unrelated chest x-ray or CT scan, for example,” says Saamia Hossain, MD, a member of the Medical Staff of Penn Medicine Princeton Health. “The seriousness of the effusion generally depends on what is causing the fluid buildup. Treating that underlying condition may resolve the problem, so diagnosing the cause is key.”
Some common causes of pleural effusion are pneumonia or a worsening of congestive heart failure, although it can occur in patients with cancer. Left untreated, fluid buildup can result in worsening of symptoms, hospitalization, and further complications. An estimated one million Americans are diagnosed with the condition every year, according to the American Lung Association.
Diagnosis and Treatment
Diagnosing pleural effusion begins with a general physical examination followed by chest imaging such as chest ultrasound, but can also be detected on a chest x-ray or CT scan. If the cause of the pleural effusion is unclear, or if it is causing symptoms, a minimally invasive technique known as a thoracentesis can be performed under local anesthesia.
“During the procedure, a sample of the fluid is taken for analysis,” says Dr. Hossain, who is board certified in critical care medicine, internal medicine, and pulmonary disease. “Tests done on the pleural fluid help us to narrow down its cause, and helps direct further treatment if needed.”
Treatment depends primarily on the cause of the initial pleural effusion, and your pulmonologist will discuss your treatment options based on the results of the testing. These can include medications and procedures to drain fluid. If these treatments fail to control the condition, both minimally invasive and traditional open surgical procedures can be performed.