Pleural Effusion: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Pleural Effusion?
A pulmonologist, a doctor who treats lung diseases, usually treats pleural effusion. A cardiologist, a heart doctor, or an oncologist, a cancer doctor, may also help, depending on the cause. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is pleural effusion?
A pleural effusion is a buildup of fluid between the layers of tissue that line the lungs and chest cavity. The pleura is a thin sheet of tissue that wraps around the outside of the lungs and lines the inside of the chest cavity. The body normally makes a small amount of pleural fluid to lubricate the surfaces of the pleura. A pleural effusion is an abnormal, excessive collection of this fluid. It is also called fluid in the chest or fluid on the lung.
Symptoms
Symptoms can include:
- Chest pain, usually sharp and worse with cough or deep breaths.
- Cough.
- Fever and chills.
- Hiccups.
- Rapid breathing.
- Shortness of breath.
Sometimes there are no symptoms.
Causes and who gets it
There are two types of pleural effusion. In one type, fluid leaks into the pleural space. This comes from higher pressure in the blood vessels or a low blood protein count. Heart failure is the most common cause. In the other type, the cause is blocked blood vessels or lymph vessels, inflammation, infection, lung injury, or tumors.
Smoking and drinking alcohol can cause heart, lung, and liver disease, which can lead to pleural effusion. Past contact with asbestos is also a risk factor.
How doctors diagnose it
Your provider will examine you and ask about your symptoms. The provider will also listen to your lungs with a stethoscope and tap on your chest and upper back. An ultrasound of the chest, a chest CT scan, or a chest x-ray may be enough to decide on treatment.
Your provider may also test the fluid. A sample is removed with a needle inserted between the ribs. The fluid is checked for infection, cancer cells, protein levels, and cell counts. Blood tests may be done to check for signs of infection or anemia. An ultrasound of the heart may be done to look for heart failure.
Treatment
The goals of treatment are to remove the fluid, prevent it from building up again, and find and treat its cause. Removing the fluid is called thoracentesis. It may be done if there is a lot of fluid causing chest pressure, shortness of breath, or a low oxygen level. In short, treatment focuses on removing fluid, relieving symptoms, and treating the underlying condition. Removing the fluid lets the lung expand, which makes breathing easier.
The cause must also be treated:
- Heart failure may be treated with diuretics (water pills) and other heart failure medicines.
- Infection is treated with antibiotics. Sometimes more treatment is needed.
- Cancer, liver disease, or kidney disease should be treated directly.
With cancer or infection, a chest tube is often used to drain the fluid. In some cases, doctors also use chemotherapy, radiation therapy, surgery, or medicine placed into the chest that keeps fluid from building up again. Complications may include lung damage, an infection that turns into an abscess called an empyema, and scarring of the lining of the lung. Air can also enter the chest cavity after the fluid is drained. This is called a pneumothorax.
When to see a doctor
Contact your provider or go to the emergency room if you have symptoms of pleural effusion. Do the same if you have shortness of breath or trouble breathing right after thoracentesis. Call 911 or go to the emergency room if you have severe trouble breathing, faint, or have a change in mental status.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can review your symptoms, order a first round of tests, and help you reach a lung specialist.
Common questions
What causes pleural effusion?
Heart failure is the most common cause. Infection, lung injury, inflammation, blocked vessels, and tumors can also cause it.
Is pleural effusion serious?
It depends on the cause, because the outcome depends on the underlying disease. Complications can include lung damage and infection that turns into an abscess, called an empyema.
How is fluid removed from the chest?
A doctor can remove it with a procedure called thoracentesis, which uses a needle inserted between the ribs. A chest tube can also drain the fluid, often in people with cancer or infection.
Can pleural effusion cause no symptoms?
Yes, sometimes there are no symptoms.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
