A simple pleural effusion or not?

Submitted: 24 April 2023
Accepted: 29 May 2023
Published: 23 June 2023
Abstract Views: 519
PDF: 248
Supplementary Materials: 126
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A 60-year-old man presented with a 2-week history of progressive dyspnea and bilateral leg edema. He had undergone a prosthetic mitral valve replacement 9 years earlier. The patient was in respiratory distress (respiratory rate 32/min, oxygen saturation 86% on air, heart rate 124/min, blood pressure 109/56 mmHg). Examination revealed bilateral lung crackles and reduced air entry with dullness to percussion and elevated jugular venous pressure. The electrocardiogram showed sinus tachycardia. A chest X-ray (CXR) (Figure 1) and bedside lung ultrasonography were performed (Figure 2A). A diagnosis of a large pleural effusion was made and urgent thoracocentesis was considered in view of the patient’s respiratory distress. A repeat ultrasonographic scan with adjusted angulation to identify the most suitable entry point for the chest drain (Figure 2B) yielded new results that led to the cancellation of the thoracocentesis.

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How to Cite

Teoh, V. W. Y., Deraman, M. A., & Loch, A. (2023). A simple pleural effusion or not?. Emergency Care Journal, 19(2). https://doi.org/10.4081/ecj.2023.11431