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Pleural effusion due to pulmonary emboli.

R W Light1

  • 1Pulmonary Diseases, Saint Thomas Hospital, Vanderbilt University, Nashville, Tennessee, USA. rlight98@yahoo.com

Current Opinion in Pulmonary Medicine
|July 27, 2001
PubMed
Summary
This summary is machine-generated.

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Pulmonary embolism (PE) is a common cause of pleural effusion, often presenting with chest pain. Early evaluation with d-dimer testing and imaging is crucial for diagnosing PE and initiating treatment.

Area of Science:

  • Pulmonology
  • Cardiology
  • Thoracic Medicine

Background:

  • Pulmonary embolism (PE) is a significant cause of pleural effusion, ranking as the fourth leading cause.
  • Undiagnosed pleural effusion warrants evaluation for potential pulmonary embolism.
  • The pathogenesis involves increased interstitial lung fluid due to ischemia or vasoactive cytokines.

Purpose of the Study:

  • To highlight the association between pulmonary embolism and pleural effusion.
  • To emphasize the diagnostic approach and initial management strategies for PE presenting with pleural effusion.

Main Methods:

  • Review of clinical presentation, diagnostic criteria, and treatment of pulmonary embolism with pleural effusion.
  • Discussion of diagnostic tools including d-dimer testing and spiral computed tomography (CT).

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Main Results:

  • Approximately 75% of patients with PE and pleural effusion experience pleuritic chest pain.
  • PE is the most frequent cause of pleuritic chest pain and pleural effusion in individuals under 40.
  • Pleural effusions from PE are typically exudative, occupy less than one-third of the hemithorax, and may cause disproportionate dyspnea.

Conclusions:

  • Pulmonary embolism should be considered in all patients with unexplained pleural effusion.
  • D-dimer testing serves as an effective screening tool, with positive results necessitating spiral CT confirmation.
  • Low-molecular-weight heparin is the preferred initial treatment for PE-associated pleural effusion.