Pleural Effusion vs Pulmonary Edema
Pleural effusion and pulmonary edema are two common lung conditions. These two share some aspects of the pathophysiology and cardiac failure, fluid overload, liver failure, and renal failure can cause both these conditions.
Pleural Effusion
We have two lungs in the thoracic cavity. Lungs are covered with two thin tissue layers called the pleura. The inner layer is adhered to the outer surface of the lung and is the visceral pleura. The layer lining the thoracic cavity is the parietal pleura. The potential space between the two layers of the pleura is the inter-pleural space. Collection of fluid inside this potential space is known as pleural effusion.
There are two types of pleural effusions; they aretransudative effusionsandexudative effusions. Pleural effusions may occur due to following reasons.
- Elevated hydrostatic pressure of pulmonary veins (cardiac failure, constrictive pericarditis, pericardial effusion and fluid overload),
- Low serum proteins (chronic liver disease, protein losing enteropathy, nephrotic syndrome, widespread skin lesions, hypothyroidism and burns),
- Infections (pneumonia, lung abscess, tuberculosis),
- Inflammation (systemic lupus erythematosus, connective tissue disorders and rheumatoid arthritis),
- Malignancy (primary lung cancers and metastatic tumors)
静水压力升高和低血清蛋白会导致渗透积液,而感染,炎症和恶性肿瘤会引起渗出液的积液。胸膜积液的患者出现呼吸急促,运动耐受性和胸膜型胸痛。腿部肿胀,头晕,缺血性胸痛,骨髓疼痛,阵发性夜间呼吸困难,腮腺肿胀,腹腔肿胀,妇科乳胶,腹部扩张,腹部延伸,慢性酒精使用,慢性腹泻,粪便尿液,炎热的尿液,皮肤皮疹,疟疾,疟疾,体重减轻,倾向于倾斜的途径,倾向于倾向于倾向的线索积液的主要原因。
On examination, there will be rapid breathing, diminished chest expansion, dull percussion note, diminished breath sounds over the affected area, and bronchial breathing above the area. Chest X-ray, ECG, full blood count, ESR, blood urea, electrolytes, spirometry, sputum microscopy, culture and arterial blood gas analysis are the routine investigations.
Treating the underlying cause will relieve the effusion. If symptomatic, effusion can be drained. Pleural fluid can then be sent for protein, glucose, pH, LDH, ANA, complement, rheumatoid factor and cytology). In recurrent pleural effusions, pleurodesis with tetracycline, bleomycin, or talc is an option.
Pulmonary Edema
肺水肿是由于排水肺静脉的静水压力升高。左心室功能差是最常见的原因。左心室衰竭可能是由于心脏病,心律失常,心肌炎,心脏心炎,液体超负荷,肾功能衰竭,全身性高血压和心室流出道阻塞。肺水肿是心室功能不良的表现之一,也是紧急入院的常见原因。
肺水肿表现为粉红色泡沫的痰,有限公司ugh, and shortness of breath, which increases while lying down. This is a medical emergency. On examination, there will be bilateral basal crepitations, high blood pressure and a rapid heart rate. Patient should be given a bed. Diuretics to clear the lungs, lower blood pressure, and treat the underlying cause for heart failure are the basic principles of management.
Pulmonary Edema vs Pleural Effusion
• Pleural effusion is the collection of fluid outside lungs while pulmonary edema is the collection of fluid inside lungs.
• Pleural fluid collects in the pleural space while edema fluid collects in alveoli.
•胸腔积液会导致胸膜型胸痛,而肺水肿则没有。
• Pleural effusion reduces chest expansion, is dull to percuss while pulmonary edema is not.
•基础薄饼在肺水肿中很突出,而支气管呼吸和诱惑(Egophony)在胸腔积液中可见。
• Pleural effusion diminishes costophrenic angles and is visible as a crescent shape at lower lung fields in the chest X-ray. In pulmonary edema, alveolar edema, Kurly B lines, cardiomegaly, dilatation of the upper lobe arterioles, and effusion may be seen in chest X-ray.
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