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Pleural effusion is the accumulation of excess fluid in the pleural cavity, which surrounds the lungs. Normally, the pleura contain a thin layer of fluid to keep the lungs moving smoothly during breathing. When there is excess fluid, it impairs breathing. Right pleural effusion occurs in the right side pleura. Right pleural effusion is more often associated with congestive heart failure than left pleural effusion.
The occurrence of right pleural effusion, or right-sided pleural effusion, is the result of an underlying disorder. Fluid levels in the right and left pleural cavities are often different, known as asymmetrical effusion. Effusion can also be isolated to one of the cavities, known as unilateral effusion. Right pleural effusion is primarily associated with congestive heart failure (CHF).
The first symptoms of pleural effusion are usually seen when the amount of fluid in the pleura reaches about 500 milliliters. Reported symptoms include both difficult or painful breathing, as well as decreased movement of the chest wall when breathing. There will also be less resonance when the chest and back are percussed, or tapped. The breathing sounds may be dull when examined with a stethoscope, and there may also be unusual sounds, such as a crackling or rubbing, due to the friction created by the excess fluid. If these symptoms are suspected, an x-ray or ultrasound will usually be done to confirm the diagnosis.
Once either right pleural effusion or left pleural effusion is diagnosed, the fluid will be taken out with a large needle placed in the back or chest, a process known as thoracentesis. The fluid will then be analyzed to determine the components of the fluid, and if the fluid is transudate or exudate. Transudate fluid indicates a systemic origin, one in which a part of the body, usually the heart, liver, or kidney, is creating an overall imbalance of the fluids of the body. Exudate fluid indicates there is a problem around or in the lungs such as a bacterial or viral infection, an embolism, or cancer, and further tests are done to get a specific diagnosis. There are other types of causes that aren’t classified, such as autoimmune diseases and surgically-induced effusion, but these are not as common.
The treatment for any type of pleural effusion is mostly based on the underlying cause, which must be treated to fix the overall issue. To reduce the amount of fluid in the pleura, a needle will be used to draw out the excess fluid. When more fluid is involved, a drain tube may be used or surgery may be performed. Other treatments include using chemicals to treat infection and surgically fusing the pleural cavity to stop fluid from accumulating.