Is the pleural effusion serious?

Whether there is fluid in the chest cavity is a very important question. So is the presence of fluid in the chest cavity serious? It depends on the amount of fluid accumulation. If it is a small amount, it is relatively easy to treat, and the patient's symptoms are not obvious, just a little chest tightness. But if it has developed more, there is a risk of illness, and of course you should seek medical treatment promptly.

When the amount of pleural effusion is less than 0.3 liters, the symptoms are not obvious; if it exceeds 0.5 liters, the patient may feel chest tightness. When doctors perform physical examinations on patients, they will find that local percussion sounds are dull and the sounds of breathing are reduced. When the amount of fluid accumulation is large, the two layers of pleura are separated and no longer rub against each other with breathing. Chest pain will gradually ease, but breathing difficulties will gradually worsen. If the effusion increases further and compresses the mediastinal organs, the patient will experience obvious palpitations and difficulty breathing. If the pleural effusion is caused by?, you can receive anti-tuberculosis treatment and symptomatic treatment. For detailed treatment advice, please consult the infectious disease department of the local hospital.

Pleural effusion is a common clinical symptom characterized by pathological fluid accumulation in the pleural cavity. The pleural cavity is a potential gap between the visceral and parietal pleura. In a normal person, there is 5 to 15 ml of fluid in the pleural cavity, which acts as a lubricant during respiratory movement. 500 to 1000 ml of fluid is formed and absorbed in the pleural cavity every day. Any reason that causes increased production or decreased absorption of fluid in the pleural cavity can cause pleural effusion. According to its occurrence mechanism, it can be divided into two categories: transudative pleural effusion and exudative pleural effusion.

Causes

Increased hydrostatic pressure in pleural capillaries (such as congestive heart failure), increased pleural permeability (such as pleural inflammation, tumors), decreased colloid osmotic pressure in pleural capillaries (such as hypoproteinemia, cirrhosis), obstruction of parietal pleural lymphatic return (such as cancerous lymphatic obstruction) and chest injury can all cause pleural effusion. The common clinical causes are as follows:

1. Transudative pleural effusion

Pleural effusions caused by congestive heart failure, constrictive pericarditis, cirrhosis, superior vena cava syndrome, nephrotic syndrome, glomerulonephritis, dialysis, myxedema, etc. are often transudates.

2. Exudative pleural effusion

(1) Pleural malignant tumors include primary mesothelioma and metastatic pleural tumor.

(2) Chest and lung infections such as tuberculosis and other bacterial, fungal, viral, and parasitic infections.

(3) Connective tissue diseases such as systemic lupus erythematosus, polymyositis, scleroderma, and Sjögren's syndrome.

(4) Lymphocyte abnormalities such as multiple myeloma and lymphoma.

(5) Drug-induced pleural diseases such as minoxidil, bromocriptine, dimethylergonovine, methotrexate, levodopa, etc.

(6) Digestive system diseases such as viral hepatitis, liver abscess, pancreatitis, esophageal rupture, and diaphragmatic hernia.

(7) Other diseases: hemothorax, chylothorax, uremia, endometriosis, radiation injury, post-myocardial infarction syndrome, etc.

Clinical manifestations

1. Symptoms

(1) Chest tightness and dyspnea. Symptoms are not obvious when the effusion is small (less than 300 ml). However, in the early stage of acute pleurisy, when the effusion is small, there may be obvious chest pain, which worsens during inhalation. The patient prefers the affected side. When the effusion increases, the visceral and parietal layers of the pleura separate, and the chest pain may be relieved or disappear. When there is moderate to large amount of pleural effusion (greater than 500 ml), shortness of breath, chest tightness, palpitations, dyspnea, and even orthopnea accompanied by cyanosis may occur.

(2) Symptoms of the primary disease: For example, patients with pleural effusion caused by tuberculosis may have symptoms of tuberculosis poisoning such as low fever, fatigue, and exhaustion; patients with heart failure have symptoms of heart failure; patients with pneumonia-related pleural effusion and pus and blood often have fever and cough with sputum; patients with liver abscess have pain in the liver area.

2. Physical signs

Patients with fibrinous pleurisy may hear or feel a pleural friction rub. When there is moderate to large amount of effusion, respiratory movement on the affected side may be restricted, breathing may be shallow and rapid, the intercostal spaces may be full, the trachea may shift toward the healthy side, the vocal tremor on the affected side may weaken or disappear, the breath sounds above the effusion area may increase, and bronchial breath sounds may sometimes be heard.