Pleural effusion is the buildup of fluid in the tissue between the lungs and the chest cavity.

Thin membranes (pleura) line the lungs and the chest wall. Your body produces a small amount of fluid to lubricate the space between the two. But the fluid can build up to abnormal levels when you’re sick or injured.

Many different conditions can result in pleural effusion. The most common ones are:

• Pneumonia
• Heart failure
• Lung cancer, breast cancer, or lymphoma that has spread
• Blood clots in the lungs
• Heart surgery
• Chest injury

Chest pain is the most common symptom of pleural effusion. It tends to be a sharp pain that feels worse when you cough or breathe deeply. You may also have a fever and chills, rapid breathing, and shortness of breath.

Our doctors will test the pleural fluid to find out what’s causing it. Once they have a diagnosis, they can treat the underlying cause.

There are many different types of pleural effusion, which include:

• Malignant pleural effusion: Cells from cancer spread into the pleural space. People with lung cancer, breast cancer, or lymphoma are the most likely to cause this.
• Infectious pleural effusion: Infected fluid accumulates in the pleural space. This fluid may come from a chest wound, surgery, or an abscess.
• Empyema: Pus in the pleural space. It’s usually a complication of pneumonia. 
• Inflammatory effusion: Some autoimmune conditions can lead to pleural effusion. The most common are rheumatoid arthritis and lupus.
• Hemothorax: Blood in the pleural space. It usually comes from a chest injury. Less often, it comes from a ruptured blood vessel or a leaking aorta (aortic aneurysm).
• Chylothorax: Fluid from a lymph node gets into the pleural space. It’s usually caused by an injury to a lymphatic duct or blockage of a duct by a tumor.
• Unexplained pleural effusion: The doctors don’t know what’s causing the fluid buildup. They'll do further testing to find out.
• Recurrent pleural effusion: Fluid buildup that keeps coming back after getting drained.

Sometimes a small amount of pleural fluid will drain away on its own. But in most cases, we need to drain the pleural fluid. Removing the fluid allows the lungs to expand and helps you breathe easier.

The goal of our treatment is to drain the fluid and keep it from coming back. It’s also key to find out what caused the fluid buildup and treat the underlying cause.

We may need to do a thoracentesis to remove a sample or drain the fluid. This procedure uses a thin needle to remove fluid from the pleural space. Or we may use a larger chest tube inserted between 2 ribs to release greater amounts of fluid.

We also treat the root cause of the fluid buildup. Depending on our findings, you may need additional care, including:

• Medicines: Diuretics (water pills) help your body remove extra fluid and antibiotics fight infection
• Cancer treatment: Chemotherapy and radiation therapy target cancer that can cause fluid buildup
• Surgery: In some cases, surgery can remove the cause of fluid or prevent it from coming back
• Treatment for recurring fluid: Medicine placed in the chest can keep fluid from building up again
• Drainage devices: A long-term chest tube can help drain fluid at home if it keeps returning
• Lung exercises: A spirometer can help strengthen your lungs after we drain the fluid