Contents
Heart failure, kidney disease, severe anemia and other diseases can be complicated by hydrothorax. In the people, this pathological condition is known as chest dropsy.
What is pulmonary hydrothorax?
Hydrothorax of the lungs is a disease in which fluid accumulates in the pleural cavity. Most often, the exudate is non-inflammatory in nature. Pathology is not independent, it mainly aggravates the course of the underlying disease. Hydrothorax is able to become a companion of diseases, which are characterized by blood stasis observed in the pulmonary circulation, high blood pressure.
The disease can take three forms:
left-sided (the rarest);
right-sided (rare);
bilateral (the most popular).
A person may first have a right-sided (left-sided) hydrothorax, then transform into a bilateral form.
Also, hydrothorax is traditionally divided into the following groups:
simple hydrothorax;
chylothorax (lymph is concentrated in the pleural cavity);
hemothorax (blood collects in the pleura).
The amount of fluid that accumulates in the pleural cavity during hydrothorax can be different – from 100 ml to several liters. As a rule, the manifestations of the patient’s disease are not disturbed if the volume of exudate does not exceed 200 ml.
Hydrothorax causes compression of the lung tissue, a decrease in its size, this happens if the fluid is collected in large quantities. It is also likely that the mediastinal organs are displaced. The result of the process can be respiratory failure, circulatory disorders, and therefore leaving the disease without treatment is extremely dangerous.
Hydrothorax can provoke a heart attack in a patient, become a source of problems with the kidneys and liver, cause pulmonary edema and other dangerous complications.
Causes of hydrothorax
Many diseases that provoke high blood pressure can cause a person to develop hydrothorax.
Among them, the following diseases and pathologies are most common:
mediastinal tumors;
cirrhosis of the liver;
defects, heart diseases (genetic, acquired);
anemia;
malabsorption syndrome;
diseases affecting the kidneys;
chest trauma;
myxedema.
Kidney disease leads to a reduction in blood plasma pressure, resulting in hydrothorax. Similarly, the disease develops with myxedema, alimentary dystrophy. With cirrhosis of the liver, pathology can also be associated with the movement of ascitic fluid into the pleural cavity from the abdominal cavity. Almost the same thing happens with peritoneal dialysis, ascites. Tumors of the mediastinum become a provocateur due to a violation of the outflow of lymph and blood.
Also, a metabolic disorder (salt, water, protein) can become a factor provoking the development of the disease.
Symptoms of hydrothorax
If the pathological accumulation of fluid takes on serious forms, the patient begins to be disturbed by shortness of breath, there is a constant feeling of heaviness in the affected half of the chest (in the right, left, both, depending on the form of hydrothorax).
Also, the disease speaks about itself with the following symptoms:
forced posture (the upper part of the body is raised, tilted towards the concentration of fluid);
chest pain;
dry cough;
redness of the skin;
swelling;
swelling of the fingers;
slight increase in temperature;
tachycardia;
difficulty falling asleep.
In addition, with hydrothorax, the patient may experience an increase in the size of the lymph nodes, pain in the muscles, and stiffness of movements may occur. And, finally, if a large amount of fluid is collected, deformation of the affected half of the chest occurs. The intercostal spaces are smoothed, the chest protrudes. It is easier for the patient to lie on the affected side, since pressure from above can be avoided in this position.
Treatment of hydrothorax
If a patient has hydrothorax, which is moderate in volume, the fight against the disease against which it developed comes to the fore. Depending on the indications, protein, diuretic drugs, and medications for the treatment of heart failure may be prescribed.
Puncture with aspiration
If a large volume of fluid is collected in the pleural cavity, the patient develops respiratory failure, the lungs are compressed, he is prescribed a puncture. The main goal of the manipulation is the slow removal of the transudate from the cavity. Suction is performed using a special thick and long needle. The procedure can also be carried out in order to clarify the diagnosis. The fluid is analyzed, which makes it possible to verify the correctness of the verdict “hydrothorax”, without confusing it with hemothorax or exudative pleurisy.
For the procedure, the patient takes a sitting position. For the purpose of pain relief, local anesthesia is used, an injection is made at the lowest point of the pleura. For one procedure, a maximum of 1.5 liters of liquid is “sucked off”. If this amount is exceeded, there is a danger of displacement of the mediastinal organs. It may also lower blood pressure. After the puncture, the puncture site is covered with a sterile dressing.
Purification of the pleural cavity from pathological fluid allows you to restore blood circulation, “start” the respiratory processes. This is a simple procedure, you do not need to prepare for it. If the problem is recurrent hydrothorax, the puncture of the pleural cavity is repeated, in difficult cases – several times.
Treatment of major diseases
Despite the simplicity of the puncture, doctors try to limit themselves to conservative treatment of the disease. Frequent repetition of fluid aspiration provides a serious loss of protein, possibly worsening hypoproteinemia.
If hydrothorax appears in a patient against the background of cirrhosis of the liver, he is prescribed a diet that reduces the intake of salt and fluid containing a sufficient amount of protein. Diuretics are also included, if indicated.
If the disease is associated with kidney disease, the appearance of nephrotic syndrome, the patient is shown bed rest to improve urine production. A diet is also prescribed that reduces the allowable amount of salt (or completely excludes this product if the patient has puffiness), the liquid being drunk is monitored. Drug therapy is also connected (depending on the specific disease).
In case of heart failure, the patient is prescribed fractional meals, a special diet program, good sleep, and avoidance of stressful situations. Medical therapy is also used. Cardiac glucosides, phosphodiesterase inhibitors are prescribed to enhance the contractile function of the myocardium. With the help of diuretics, the body gets rid of excess fluid. Drugs are also taken that reduce the load that falls on the left ventricle of the heart.
The best prevention of hydrothorax is the timely and adequate treatment of diseases that can create conditions for its development. It is also recommended to avoid any injury to the chest.