Abstract
Transudative pleural and pericardial effusions are not uncommon in patients with congestive
heart failure. Pericardial effusion forms only with elevation of the right-sided filling
pressure in the heart. In patients with biventricular failure, there is no evidence
that elevated left-sided pressure, in the absence of elevated right-sided pressure,
can cause a pericardial effusion. Pleural effusion forms with acute elevation of the
right-sided or the left-sided filling pressure in the heart. In patients with congestive
heart failure, elevated right-sided filling pressures are less common than elevated
left-sided filling pressures, thus, explaining a lower prevalence of pericardial than
pleural effusions. Pleural effusions in patients with congestive heart failure are
typically bilateral. However, a unilateral pleural effusion is more commonly seen
on the right side. Although multiple theories attempt to explain the right-sided preponderance
of pleural effusion, to date, no mechanism has been universally accepted or experimentally
proven.
Key Indexing Terms
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Article info
Publication history
Accepted:
March 3,
2009
Received:
December 15,
2008
Identification
Copyright
© 2009 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
