Pleural Effusion

Pleural effusions are accumulations of fluid in the lung pleural space, either due to increased production or decreased reabsorption. It is often a complication of a known underlying disease and can be asymptomatic or present as progressive shortness of breath (dyspnea).

objectives

In this module, Dr. Marcio Gomes will discuss the approach to a patient presenting with pleural effusion. In addition to reviewing the initial evaluation of a patient, such as temporal evolution and severity of dyspnea, critical questions to ask in history, including whether there is a known systemic illness or malignancy and whether there is associated respiratory symptoms will also be reviewed. The clinical significance of specific signs on physical examination, such as asymmetric thoracic expansion and pulmonary crackles, will be discussed, as will the details of investigations that should be performed, such as diagnostic thoracentesis.  Lastly, you will learn a comprehensive diagnostic approach to pleural effusion, how to manage an acute presentation, how to differentiate between exudates and transudates, and how to evaluate and manage common causes of pleural effusion, such as congestive heart failure and pneumonia.