ABSTRACT
I. Introduction Today, life expectancy is increasing in all countries of the world except those that are extremely poor. This means, of course, that more and more people are living longer and longer and will suffer from classic old-age-related medical complications: heart disease, cancer, COPD, and Alzheimer’s, and other neurodegenerative diseases. More heart disease means more heart failure with accompanying pleural effusions, the accumulation of transudative liquid in, often, both pleural spaces. Most patients with cardiogenic pleural effusions have congestive failure from some variety of left-sided heart disease; less commonly, pericardial disease or various types of cardiac injury, including heart surgery, may be associated with pleural effusion. Patients with heart disease may also develop pleural effusions of noncardiac origin, especially those caused by pulmonary emboli and bacterial pneumonia. The diagnosis of cardiac-related pleural effusions is ordinarily straightforward, and treatment is focused on the underlying heart disease; sometimes, though, as pointed out in this chapter, variations on the familiar clinical themes may confuse and complicate matters for both patients and physicians.
