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Pleural effusion in patients with pulmonary embolism
Elaine Yap1, Graeme Anderson, Jennifer Donald
1Department of Respiratory Medicine, Middlemore Hospital, Auckland, New Zealand.
Respirology (Carlton, Vic.)
|July 29, 2008
Summary
Pleural effusion is common in patients with pulmonary embolism (PE), often small and ipsilateral. Clinicians should consider other diagnoses for large or contralateral effusions.
Area of Science:
- Pulmonology
- Radiology
- Thoracic Medicine
Background:
- Pulmonary embolism (PE) is a potential, under-recognized cause of pleural effusion.
- Understanding the incidence and clinical significance of pleural effusion in PE is crucial.
Purpose of the Study:
- To determine the incidence and clinical relevance of pleural effusion in patients with pulmonary embolism.
- To investigate the relationship between emboli location, number of pulmonary arteries involved, and pleural effusion development.
Main Methods:
- Retrospective analysis of CT pulmonary angiograms (CTPA) over 12 months.
- Inclusion of adult patients with clinically suspected PE undergoing CTPA as first-line investigation.
Main Results:
- Pulmonary embolism (PE) was identified in 21% of CTPA scans (60/285 patients).
- Pleural effusion was present in 48% of patients with PE, typically small and ipsilateral to the emboli.
- No significant association found between emboli location or number of affected arteries and the presence of pleural effusion.
Conclusions:
- Pleural effusion is a frequent finding in patients with CTPA-proven pulmonary embolism.
- These effusions are generally small and rarely impact clinical management.
- Alternative diagnoses should be considered for large or contralateral pleural effusions in PE patients.
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