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Who Needs Thoracentesis?

Your doctor may recommend 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).

Doctors use thoracentesis to find the cause of a pleural effusion. The procedure also might be done to remove excess fluid from the pleural space and help you breathe easier.

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 (PULL-mun-ary EM-bo-lizm), and other lung infections. Asbestosis (as-bes-TOE-sis), sarcoidosis (sar-koy-DO-sis), and reactions to some drugs also can lead to a pleural effusion.

Diagnosing a Pleural Effusion

Your doctor will diagnose a pleural effusion based on your medical history, a physical exam, and test results.

Medical History

Your doctor will ask about your symptoms, such as trouble breathing, coughing, and hiccups. He or she also may ask 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 (a mineral that, in the past, was widely used in many industries)

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. Your doctor also may hear a dull sound when tapping on your chest.

Diagnostic Tests

You may have one or more of the following tests to diagnose a pleural effusion.

  • Chest x ray. This test creates a picture of the structures inside your chest, such as your heart and lungs. A chest x ray may show air or fluid in the pleural space. The test also may show the cause of the pleural effusion, such as pneumonia or a lung tumor. To get more detailed pictures, the x ray might be done while you're in various positions.
  • Ultrasound. This test uses sound waves to create a picture of the structures in your body, such as your lungs. Ultrasound may show the location of fluid in your chest. Sometimes the test is used to find the right place to insert the needle or tube for thoracentesis.
  • Chest computed tomography (to-MOG-rah-fee) scan, or chest CT scan. This test creates a computer-generated picture of the lungs that can show pockets of fluid. A chest CT scan may show fluid even if a chest x ray doesn't. A CT scan also may show signs of pneumonia or a tumor.
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Last Updated: February 24, 2012