Who Needs Thoracentesis?
You may need thoracentesis if you have a
pleural
effusion. A pleural effusion is the buildup of excess fluid in the pleural
space (the space between the lungs and chest wall).
Thoracentesis helps find the cause of the pleural
effusion. It also may be done to help you breathe easier, if there's a lot of
fluid in the pleural space.
The most common cause of a pleural effusion is
heart
failure. This is a condition in which the heart can't pump enough blood to
the body.
Other causes include lung cancer, tumors,
pneumonia,
tuberculosis,
pulmonary
embolism, and other lung infections.
Asbestosis,
sarcoidosis,
and reactions to some drugs also can lead to a pleural effusion.
Diagnosing a Pleural Effusion
A pleural effusion is diagnosed based on your
medical history, a physical exam, and test results.
Medical History
Your doctor will ask about your symptoms, like
trouble breathing, coughing, and hiccups. Other things your doctor may ask
about include whether you've ever:
- Had heart disease
- Smoked
- Traveled to places where you may have been
exposed to tuberculosis
- Had a job that exposed you to asbestos
Physical Exam
Your doctor will listen to your breathing with a
stethoscope and tap lightly on your chest. If you have a pleural effusion, your
breathing may sound muffled. There also may be a dull sound when your doctor
taps on your chest.
Diagnostic Tests
Your doctor may use one or more of the following
tests to diagnose a pleural effusion.
- Chest x ray. This test takes pictures of your
heart and lungs. It may show air or fluid in the pleural space. It also may
show what's causing the pleural effusion, such as pneumonia or a lung tumor. To
get more detailed pictures, the x rays may be done while you're in
different positions.
- Ultrasound. This test uses sound waves to create
pictures of your lungs. It may show where fluid is in your chest. Sometimes
it's used to find the right place to insert the needle or tube for
thoracentesis.
- Computed tomography (CT) scan. This test provides
a computer-generated picture of the lungs that can show pockets of fluid. It
may show fluid when a chest x ray doesn't. It also may show signs of pneumonia
or a tumor.
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