title: Pleural effusion in pulmonary embolism.
abstract: OBJECTIVE
  Pulmonary embolism is a common and potentially lethal disease that recurs frequently and is associated with long-term impairment and suffering. Patients with pulmonary embolism are at risk of death, recurrence of embolism, or chronic morbidity. Appropriate therapy can reduce the incidence of all. Pulmonary embolism is the most commonly overlooked disorder in patients with pleural effusion. Recent findings of pleural effusions due to pulmonary embolism are discussed in this review.
  
  
  RESULTS
  The presence of pleuritic chest pain in a patient with a pleural effusion is highly suggestive of pulmonary embolism. Nearly all pleural effusions due to pulmonary embolism are exudates, frequently hemorrhagic, and with a marked mesothelial hyperplasia. Patients with a pleural effusion are likely to have an embolus in the central, lobar, segmental, or subsegmental pulmonary arteries and these are the regions in which spiral computed tomography pulmonary angiography (CTPA) can detect an embolus. No specific treatment is required for pleural effusion. The presence of bloody pleural fluid is not a contraindication for the administration of anticoagulant therapy.
  
  
  CONCLUSIONS
  Pulmonary embolism is probably responsible for a significant percentage of undiagnosed exudative pleural effusions. Spiral CTPA is the best way to evaluate the possibility of pulmonary embolism in a patient with a pleural effusion. The treatment protocol of the patient with pleural effusion secondary to pulmonary embolism is the same as that for any patient with pulmonary embolism.
authors.affiliation: Department of Pulmonary Medicine, Medical Park Bahcelievler Hospital, Istanbul, Turkey. serhatfindik1@yahoo.com
authors.forename: Serhat
authors.initials: S
authors.lastname: Findik
mesh_terms: D000792:Angiography / Q000379:methods*; D000925:Anticoagulants / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D011655:Pulmonary Embolism / Q000150:complications* / Q000175:diagnosis / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed / Q000379:methods*; D014692:Ventilation-Perfusion Ratio
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight