The evaluation of pleural effusions in patients with heart failure

Am J Med. 2001 Oct 1;111(5):375-8. doi: 10.1016/s0002-9343(01)00881-6.


Purpose: To determine the causes of pleural effusions in patients with heart failure, and the association of the characteristics of these statistics with the use of diuretics.

Subjects and methods: Eighty-one patients with a definite diagnosis of heart failure who underwent thoracentesis were evaluated. Fluids were classified as transudates or exudates using Light's criteria.

Results: Forty-one effusions (in 34 patients) were transudates, and 54 (in 47 patients) were exudates. A specific cause was found for 32 of the exudates (27 patients); except for heart failure, no obvious cause was found for the remaining 22 fluids (20 patients). Exudates with a specific cause for an exudate were more likely to have at least two of Light's criteria (18 of 27 [67%]) than did exudates without a known cause (2 of 21 [10%]). Intravenous diuretic therapy in the 24 hours before thoracentesis was significantly more common among patients with exudates without a specific cause.

Conclusions: Patients with heart failure may have exudative pleural effusions without an obvious cause except heart failure.

MeSH terms

  • Aged
  • Diuretics / administration & dosage
  • Exudates and Transudates / chemistry
  • Female
  • Heart Failure / complications*
  • Heart Failure / drug therapy
  • Humans
  • Male
  • Pleural Effusion / diagnosis
  • Pleural Effusion / etiology*
  • Pleural Effusion / mortality
  • Retrospective Studies
  • Risk Factors
  • Statistics, Nonparametric
  • Survival Analysis


  • Diuretics