Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
The most common symptom of pleural effusion is shortness of breath or
difficulty breathing. As the
effusion grows larger the more difficult it is for the person to breathe.
Chest pain is also a symptom of pleural effusion and occurs because the pleural lining of the lung is irritated. The
pain is usually described as a sharp pain, worsening with
a deep breath.
As the pleural effusion increases in size, the pain also may increase.
Other associated symptoms of pleural effusion are due to the underlying
disease. For example, a person with congestive heart failure may have signs and
symptoms of feet swelling and shortness of breath while laying flat. Someone
with pneumonia may have a fever, chills, and a cough that produces colored
sputum and pleural pain.
What is pleural effusion?
A pleural effusion is a collection of fluid in the space between the two
linings (pleura) of the lung.
When we breathe, it is like a bellows. We inhale air into our lungs and the ribs move out and the diaphragm moves down. For the lung to expand, its lining has to slide along with the chest wall
movement. For this to happen, both the lungs and the ribs are covered with a
slippery lining called the pleura. A small amount of fluid acts as a lubricant
for these two surfaces to slide easily against each other.
Too much fluid impairs the ability of the lung to expand and move.
What causes pleural effusion?
A pleural effusion is not normal. It is not a disease but rather a
complication of an underlying illness. Extra fluid (effusion) can occur for a
variety of reasons. Common classification systems divide pleural effusions based
on the chemistry composition of the fluid and what causes the effusion to be
formed. Two classifications are 1) transudate pleural effusions; and 2) exudate
pleural effusions. Sometimes the pleural effusion can have characteristics of
both a transudate and an exudate.
1. Transudate pleural effusions are formed when fluid leaks from blood
vessels into the pleural space. Chemically, transudate pleural effusions contain
less protein and LDH (lactate dehydrogenase) than exudate pleural effusions. If
both the pleural fluid–to–serum total protein ratio is less than or equal to
0.50 and the pleural fluid–to–serum LDH ratios are less than or equal to 0.67,
the fluid is usually considered to be a transudate while exudates ratios are
above 0.50 and above 0.67.
Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss, dehydration, medication. Some of the renal causes of kidney failure are from sepsis, medications, rhabdomyolysis, multiple myeloma, and acute glomerulonephritis. Post renal causes of kidney failure include bladder obstruction, prostate problems, tumors, or kidney stones. Treatment options included diet, medications, or dialysis.
Congestive heart failure (CHF) is a condition in which the heart's function as a pump is inadequate to meet the body's needs. A poor blood supply resulting from congestive heart failure may cause the body's organ systems to fail, leading to a weakened heart muscle and fluid accumulation in the lungs and body tissue. There are many diseases that can impair pumping efficiency and symptoms of congestive heart failure including fatigue, diminished exercise capacity, shortness of breath, and swelling. Treatments include lifestyle modifications, medications, heart transplant, and therapy.
Pneumonia is inflammation of one or both lungs with consolidation. Pneumonia is frequently but not always due to infection. The infection may be bacterial, viral, fungal or parasitic. Symptoms may include fever, chills, cough with sputum production, chest pain, and shortness of breath.
Lung cancer kills more men and women than any other form of cancer. Eight out of 10 lung cancers are due
to tobacco smoke. Lung cancers are classified as either small cell or non-small
cell cancers.
Hypothyroidism is any state in which thyroid hormone production is below normal. Normally, the
rate of thyroid hormone production is controlled by the brain at the pituitary.
Hypothyroidism is a very common condition and the symptoms of hypothyroidism are
often subtle.
Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis bacteria. Symptoms include weakness, fever, weight loss, night sweats and in worse cases, chest pain, shortness of breath, and coughing up blood. A person with an active infection (a positive TB skin test, abnormal chest x-ray and TB bacteria in their sputum) requires treatment with izoniazid, rifampin, ethambutol and pyrazinaide.
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections. Symptoms include yellowing of the skin, itching, and fatigue.
Liver disease can be cause by a variety of things including infection (hepatitis), diseases such as gallstones, high cholesterol or triglycerides, blood flow obstruction to the liver, and toxins (medications and chemicals). Symptoms of liver disease depends upon the cause; however, common symptoms may include nausea, vomiting, upper right abdominal pain, and jaundice. Treatment depends upon the cause of the liver disease.
Systemic lupus erythematosus is a condition characterized by chronic inflammation of body tissues caused by autoimmune disease. Lupus can cause disease of the skin, heart, lungs, kidneys, joints, and nervous
system. When only the skin is involved, the condition is called discoid lupus.
When internal organs are involved, the condition is called systemic lupus
erythematosus (SLE).
A pulmonary embolism occurs when a piece of a blood clot from deep vein thrombosis (DVT) breaks off and travels to an artery in the lung where it blocks the artery and damages the lung. The most common symptoms of a pulmonary embolism are shortness of breath, chest pain, and a rapid heart rate.
Breast cancer is the most common cancer in women and the second most common cause of cancer death in women in the U.S. Symptoms include a lump in the breast or underarm area, nipple pain, change in breast size or shape, an inverted nipple, nipple discharge, and breast skin changes. Treatment may involve chemotherapy, radiation therapy, biological therapy, hormone therapy, or surgery.
Hashimoto's thyroiditis is the most common cause of hypothyroidism in the US. This conditions is caused by inflammation of the thyroid gland. Symptoms may include: fatigue, weight gain, cold intolerance, excessive sleepiness, dry or coarse hair, difficulty swallowing, a lump in the front of the throat, and many more. Treatment is usually hypothyroid medication.
Ascites, the accumulation of fluid in the abdominal cavity is most commonly caused by cirrhosis of the liver. Some of the other causes of ascites include portal hypertension, congestive heart failure, blood clots, and pancreatitis. The most common symptoms include increased abdominal girth and size, abdominal bloating, and abdominal pain. Treatment depends on the cause of ascites.
Chest pain is a common complaint by a patient in the ER. Causes of chest pain include broken or bruised ribs, pleurisy, pneumothorax, shingles, pneumonia, pulmonary embolism, angina, heart attack, costochondritis, pericarditis, aorta or aortic dissection, and reflux esophagitis. Diagnosis and treatment of chest pain depends upon the cause and clinical presentation of the patient's chest pain.
Pleurisy, an inflammation of the lining around the lungs, is associated with sharp chest pain upon breathing in. Cough, chest tenderness, and shortness of breath are other symptoms associated with pleurisy. Pleurisy pain can be managed with pain medication and by external splinting of the chest wall.
A pneumothorax is free air in the chest outside the lung, that causes the lung to collapse (collapsed lung). There are two types of pneumothorax, spontaneous or primary pneumothorax and secondary pneumothorax. Symptoms include sudden chest pain, shortness of breath, rapid heart rate, rapid breathing, cough, and fatigue.
Pulmonary edema (swelling or fluid in the lungs) can either be caused by cardiogenic causes (congestive heart failure, heart attacks, abnormal heart valves) or noncardiogenic causes such as ARDS, kidney failure, high altitude, pneumothorax, pleural effusion, aspirin overdose, pulmonary embolism, and infections. The treatment of pulmonary edema depends on the cause of the condition.
Pancreatic cysts are collections of fluid within the pancreas. Some are benign, malignant, or pseudocysts. There are two major types of pancreatic cysts, inflammatory cysts and non-inflammatory cysts. Non-inflammatory cysts include: serous cyst adenomas, mucinous cyst adenomas, intraductal papillary mucinous neoplasm (IPMN), and solid pseudopapillary tumor of the pancreas. Symptoms of pancreatic cysts include abdominal pain, jaundice, fever, chills, and sepsis. Treatment depends on the type of cyst, and patient health.
Asbestos exposure lung disease is divided into three main types, asbestosis (lung scarring caused by asbestos fibers), disease of the lining of the lung (pleural plaques, scarring, or fluid accumulation), and lung cancer. Mesothelioma is cancer of the lining of the lung caused by asbestos exposure. Cancers of the larynx, throat, kidney, esophagus, and gallbladder have been linked to asbestos exposure. Treatment is dependant upon the type of condition related to asbestos exposure.
Dilated Cardiomyopathy is a condition where the heart's ability to pump blood is decreased because the heart's main pumping chamber is enlarged and weakened. Symptoms of dilated cardiomyopathy include chest pain, heart failure, swelling of the lower extremities, fatigue, weight gain, fainting, palpitations, dizziness and blood clots.
Mesothelioma is a form of cancer that forms in the chest lining (pleural mesothelioma), abdomen (peritoneal mesothelioma), and the heart sac (pericardial mesothelioma) in rare cases. Chest pain, shortness of breath, weight loss, and night sweats are symptoms and signs of mesothelioma. Treatment depends upon the stage and type of mesothelioma.
The pancreas is an organ approximately six inches long that is located in the
abdomen behind the stomach. The pancreas is divided into three regions; the
head, the body, and the tail. The head of the pancreas is located in the right
abdomen adjacent to the duodenum, the tail is in the left abdomen, and the body
lies between the head and the tail.
The pancreas makes several hormones that are released into the
blood--including insulin to regulate blood glucose levels (see the
Diabetes Mellitus article)-as well as digestive enzymes that aid in the digestion of
food, for example, amylase. The digestive enzymes produced by the pancreas are
combined in a bicarbonate-rich fluid also produced by the pancreas. The
pancreatic duct within the pancreas collects the bicarbonate-rich fluid and
digestive enzymes and drains them into the duodenum, the first ...
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