The evaluation of pleural effusions in patients with heart failure.
OBJECTIVE
To determine the causes of pleural effusions in patients with heart failure, and the association of the characteristics of these statistics with the use of diuretics.


METHODS
Eighty-one patients with a definite diagnosis of heart failure who underwent thoracentesis were evaluated. Fluids were classified as transudates or exudates using Light's criteria.


RESULTS
Forty-one effusions (in 34 patients) were transudates, and 54 (in 47 patients) were exudates. A specific cause was found for 32 of the exudates (27 patients); except for heart failure, no obvious cause was found for the remaining 22 fluids (20 patients). Exudates with a specific cause for an exudate were more likely to have at least two of Light's criteria (18 of 27 [67%]) than did exudates without a known cause (2 of 21 [10%]). Intravenous diuretic therapy in the 24 hours before thoracentesis was significantly more common among patients with exudates without a specific cause.


CONCLUSIONS
Patients with heart failure may have exudative pleural effusions without an obvious cause except heart failure.
Gotsman
I
I
Department of Cardiology (IG), Hadassah University Hospital, Hebrew University, Hadassah Medical School, Jerusalem, Israel.
Fridlender
Z
Z
Meirovitz
A
A
Dratva
D
D
Muszkat
M
M
D000368:Aged; D004232:Diuretics / Q000008:administration & dosage; D005122:Exudates and Transudates / Q000737:chemistry; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D010996:Pleural Effusion / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D016019:Survival Analysis
D004232:Diuretics