Pleural effusion is a buildup of excess fluid between the pleura, layered membranes that line the lungs and chest cavity. There are two types of pleural effusion. Transudative effusion occurs when fluid leaks into the pleural space because of increased blood pressure. Exudative effusion occurs when blood or lymph vessels are blocked because inflammation, infection or injury has led to drainage problems or excess fluid production.
Causes of pleural effusion include certain types of cancer, such as lymphoma, mesothelioma, and breast, lung and ovarian cancers. It can also result from a range of other health conditions, including heart disease, heart failure, pulmonary embolism (a blood clot that blocks blood flow to a lung), pneumonia, kidney disease, liver disease and lung collapse.
Our approach to pleural effusion
UCSF's thoracic surgeons and pulmonologists are skilled and highly experienced in treating both pleural effusion and its underlying causes. Working as a team, they provide leading-edge care for pleural effusion that aims to both remove excess fluid and prevent future buildup. Our experts will also work to diagnose any related health conditions, such as infection, cancer or heart disease, and connect you with UCSF specialists who can provide the right care. Before, during and after treatment, our patients can also access support services designed to improve recovery and decrease complications.
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No. 8 in the nation for pulmonology & lung surgery
Signs & symptoms
Some patients with pleural effusion don't experience symptoms, and the condition is discovered during a routine physical exam or chest X-ray for another purpose. Others may experience one or more of the following:
- Shortness of breath
- Pain, tightness or heaviness in the chest
- Dry cough
The first step is for your doctor to conduct a physical exam and listen to the air flow in your lungs. The following tests may also be used to diagnose and localize the condition:
- Chest X-ray. These images are often sufficient to reveal the fluid buildup caused by pleural effusion.
- CT scan. To take images, a thin X-ray beam rotates around the chest area; then a computer program processes the data to construct a three-dimensional, cross-sectional image.
- Ultrasound. High-frequency sound waves are used to create images of structures inside the body. Ultrasound can detect pleural effusion and show its location.
- Thoracentesis. In this procedure, a needle is inserted into the chest cavity to remove fluid. Thoracentesis can be used to drain excess fluid, which can then be analyzed to help determine the cause of pleural effusion.
- Pleural biopsy. This involves removing a tissue sample from the pleura to check for certain diseases and infections that can cause pleural effusion.
- Fluid drainage. Removing fluid from the chest cavity can relieve the symptoms of pleural effusion and allow the lungs to inflate more fully. One minimally invasive drainage method is thoracentesis, which involves inserting a needle into the chest cavity to remove the excess fluid. For recurrent or severe pleural effusion, your doctor may place a small tube in the chest to address significant fluid buildup. The tube can be used to insert medication that prevents fluid from accumulating or it can be attached to a suction device that removes extra fluid or air.
- Pleurodesis. This surgical treatment may be used for patients with recurrent pleural effusion due to an underlying condition, such as cancer. After removing fluid from the chest cavity, doctors administer a medication that causes the lung to stick to the chest wall, preventing future fluid buildup.
- Treating the underlying condition. Depending on the cause of your pleural effusion, your doctor may recommend additional treatment to prevent a recurrence. If you have a bacterial infection, this will likely involve antibiotics, administered orally or intravenously. Patients with heart failure, cancer, liver disease, kidney disease or another underlying condition will receive additional treatments tailored to their needs.
UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.