What are the main symptoms of costochondritis. How is costochondritis diagnosed. What are the most effective treatments for costochondritis. Can lifestyle changes help manage costochondritis symptoms. When should you seek medical attention for chest pain related to costochondritis.

Understanding Costochondritis: An Overview of Rib Cage Inflammation

Costochondritis is a condition characterized by inflammation of the cartilage in the rib cage, specifically where the upper ribs attach to the breastbone (sternum) at the costosternal joint. This inflammatory condition can cause varying degrees of chest pain, ranging from mild discomfort to severe, debilitating pain. While costochondritis often resolves on its own within weeks or months, some cases may require medical intervention and treatment.

What Causes Costochondritis?

The exact cause of costochondritis remains unknown in many cases. However, several factors have been identified as potential triggers:

• Trauma to the chest (e.g., blunt impact from a car accident or fall)
• Physical strain from activities like heavy lifting or strenuous exercise
• Viral infections or respiratory conditions (e.g., tuberculosis) causing joint inflammation
• Severe coughing

Research suggests that costochondritis may occur more frequently in women, particularly those who are athletes. Individuals who participate in high-impact activities, have recently experienced physical trauma to the chest area, or have allergies with frequent exposure to irritants may also be at higher risk for developing this condition.

Recognizing the Symptoms of Costochondritis

Identifying the symptoms of costochondritis is crucial for proper diagnosis and treatment. The primary symptom is chest pain, typically localized in the upper and middle rib area on either side of the breastbone. This pain can develop gradually or come on suddenly, and may be accompanied by other symptoms:

• Pain that worsens when lying down
• Increased discomfort when pressure is applied to the chest (e.g., wearing a seatbelt)
• Pain that intensifies with coughing or deep breathing
• Discomfort that increases during physical activity

It’s important to note that chest tightness and radiating pain can also be indicators of more serious conditions, such as a heart attack. If you experience persistent, intense chest pain, it’s crucial to seek immediate medical attention to rule out potentially life-threatening causes.

Diagnosing Costochondritis: What to Expect

Diagnosing costochondritis can be challenging, as there is no specific test to confirm the condition. Instead, healthcare providers rely on a combination of patient history, physical examination, and diagnostic tests to rule out other potential causes of chest pain.

The Diagnostic Process

When diagnosing costochondritis, your doctor will likely follow these steps:

1. Take a detailed medical history and ask about your symptoms
2. Perform a physical examination, including palpation of the chest wall
3. Order diagnostic tests to rule out other conditions

While laboratory tests are not typically necessary for diagnosing costochondritis, your doctor may recommend certain tests based on your health history to exclude other potential causes of chest pain, such as pneumonia or coronary heart disease.

Imaging and Other Diagnostic Tools

To ensure a thorough evaluation, your doctor may also recommend:

• Chest X-rays to check for any abnormalities in the lungs
• Electrocardiogram (ECG) to rule out heart-related issues

In most cases of costochondritis, these tests will appear normal. The diagnosis is often made by eliminating other possible, more serious causes of chest pain.

Effective Treatment Options for Costochondritis

Once diagnosed, costochondritis can be managed through various treatment approaches. The primary goal of treatment is to alleviate pain and reduce inflammation. Here are some of the most effective options:

Medication-Based Treatments

For mild to moderate cases of costochondritis, over-the-counter medications are often the first line of treatment. These may include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen
• Prescription-strength NSAIDs for more severe cases
• Oral steroids or steroid injections into the affected area

Non-Pharmacological Approaches

In addition to medication, your doctor may recommend other treatments to manage costochondritis symptoms:

• Transcutaneous electrical nerve stimulation (TENS), which delivers mild electric currents to the affected area
• Physical therapy to improve posture and strengthen chest muscles
• Hot or cold therapy using heating pads and ice packs

Lifestyle Modifications for Managing Costochondritis

For individuals with persistent or chronic costochondritis, making certain lifestyle changes can be beneficial in managing symptoms and preventing flare-ups.

Exercise and Activity Modifications

Some types of physical activity can exacerbate costochondritis symptoms. Your doctor may advise you to avoid or modify activities such as:

• Rowing
• Weightlifting
• Certain types of manual labor

Instead, focus on low-impact exercises and activities that don’t put excessive strain on the chest area.

Rest and Recovery

Allowing your body adequate time to rest and recover is crucial in managing costochondritis. This may involve:

• Taking breaks during physical activities
• Using proper posture and ergonomics when sitting or standing for long periods
• Getting sufficient sleep to promote healing

When to Seek Medical Attention for Costochondritis

While costochondritis is generally not a serious condition, it’s important to know when to seek medical attention. Consult your healthcare provider if you experience:

• Persistent or worsening chest pain
• Difficulty breathing
• Fever or other signs of infection
• Pain that interferes with your daily activities

Remember, any sudden or severe chest pain should be evaluated immediately to rule out more serious conditions such as heart attacks or pulmonary embolisms.

Long-Term Management and Prognosis of Costochondritis

For most individuals, costochondritis resolves on its own with appropriate treatment and management. However, some people may experience chronic or recurring symptoms that require ongoing care.

Chronic Costochondritis Management

If you have chronic costochondritis, your healthcare provider may recommend:

• Long-term pain management strategies
• Regular follow-up appointments to monitor your condition
• Lifestyle modifications to prevent symptom flare-ups

Prognosis and Quality of Life

With proper management, most people with costochondritis can maintain a good quality of life. However, it’s important to work closely with your healthcare team to develop a personalized treatment plan that addresses your specific needs and symptoms.

Is costochondritis a permanent condition? While some individuals may experience chronic or recurring symptoms, many cases of costochondritis resolve completely with appropriate treatment and management. The prognosis is generally good, but it’s essential to follow your doctor’s recommendations and make necessary lifestyle adjustments to minimize the impact on your daily life.

Prevention Strategies for Costochondritis

While it may not always be possible to prevent costochondritis, there are steps you can take to reduce your risk of developing this condition or experiencing recurrent episodes.

Ergonomic Considerations

Proper ergonomics can help reduce strain on your chest and ribcage. Consider the following tips:

• Maintain good posture while sitting and standing
• Use ergonomic equipment at work and home
• Take regular breaks during activities that involve repetitive chest movements

Exercise and Stretching

Incorporating specific exercises and stretches into your routine can help strengthen the chest muscles and improve flexibility:

• Gentle chest stretches
• Core-strengthening exercises
• Low-impact cardiovascular activities

Always consult with a healthcare professional or physical therapist before starting any new exercise regimen, especially if you have a history of costochondritis.

Stress Management

Stress can exacerbate inflammation in the body, potentially triggering or worsening costochondritis symptoms. Implementing stress-reduction techniques may help prevent flare-ups:

• Practice mindfulness meditation
• Engage in deep breathing exercises
• Participate in relaxation activities like yoga or tai chi

How does stress management contribute to costochondritis prevention? By reducing overall inflammation in the body and promoting relaxation of chest muscles, stress management techniques can help minimize the risk of developing costochondritis or experiencing symptom recurrence.

Differential Diagnosis: Distinguishing Costochondritis from Other Conditions

Given that chest pain is a common symptom of various medical conditions, it’s crucial to differentiate costochondritis from other potential causes. Healthcare providers must consider several possibilities when evaluating a patient with chest pain.

Common Conditions to Rule Out

Some conditions that may present with similar symptoms to costochondritis include:

• Acute coronary syndrome
• Pneumonia
• Pulmonary embolism
• Gastroesophageal reflux disease (GERD)
• Fibromyalgia

Diagnostic Challenges

Distinguishing costochondritis from these conditions can be challenging, as symptoms may overlap. Healthcare providers use a combination of clinical assessment, patient history, and diagnostic tests to make an accurate diagnosis.

Why is accurate diagnosis crucial in cases of chest pain? Proper identification of the underlying cause ensures that patients receive appropriate treatment and helps prevent potentially life-threatening conditions from being overlooked.

The Role of Complementary and Alternative Medicine in Costochondritis Management

While conventional medical treatments form the cornerstone of costochondritis management, some individuals may find relief through complementary and alternative medicine (CAM) approaches. It’s important to note that these methods should be used in conjunction with, not as a replacement for, traditional medical care.

Potential CAM Therapies for Costochondritis

Some complementary therapies that may offer relief for costochondritis symptoms include:

• Acupuncture
• Massage therapy
• Herbal supplements with anti-inflammatory properties
• Chiropractic care

Always consult with your healthcare provider before incorporating any CAM therapies into your treatment plan to ensure safety and avoid potential interactions with other medications or treatments.

Evaluating the Effectiveness of CAM Approaches

While some individuals report benefits from CAM therapies, scientific evidence supporting their effectiveness for costochondritis is limited. It’s essential to approach these treatments with a critical eye and monitor your response closely.

How can patients safely explore CAM options for costochondritis? Work closely with your healthcare team to develop an integrated approach that combines evidence-based conventional treatments with carefully selected complementary therapies, ensuring a comprehensive and personalized management plan.

The Impact of Costochondritis on Mental Health and Well-being

Living with chronic pain conditions like costochondritis can have significant effects on an individual’s mental health and overall quality of life. It’s important to address both the physical and psychological aspects of the condition for comprehensive care.

Psychological Effects of Chronic Pain

Individuals with costochondritis may experience:

• Anxiety, particularly related to chest pain and potential cardiac concerns
• Depression due to persistent pain and activity limitations
• Frustration with ongoing symptoms and treatment challenges
• Social isolation if pain interferes with daily activities

Coping Strategies and Support

To address the mental health aspects of costochondritis, consider the following approaches:

• Seek support from a mental health professional
• Join support groups for individuals with chronic pain conditions
• Practice stress-reduction techniques like mindfulness and meditation
• Engage in activities that bring joy and distraction from pain

How does addressing mental health contribute to overall costochondritis management? By focusing on both physical and psychological well-being, individuals can develop a more resilient approach to managing their condition, potentially improving treatment outcomes and quality of life.

Future Directions in Costochondritis Research and Treatment

As medical understanding of costochondritis continues to evolve, researchers are exploring new avenues for diagnosis, treatment, and prevention of this condition. Staying informed about emerging research can help patients and healthcare providers make more informed decisions about management strategies.

Emerging Diagnostic Tools

Researchers are investigating advanced imaging techniques and biomarkers that may improve the accuracy and efficiency of costochondritis diagnosis. These may include:

• High-resolution ultrasound imaging
• Magnetic resonance imaging (MRI) protocols specific to chest wall inflammation
• Inflammatory markers in blood tests

Innovative Treatment Approaches

New treatment modalities under investigation for costochondritis include:

• Targeted anti-inflammatory medications
• Regenerative medicine techniques, such as platelet-rich plasma therapy
• Advanced physical therapy protocols
• Wearable devices for pain management

What potential benefits could these emerging treatments offer to costochondritis patients? As research progresses, these innovative approaches may provide more effective, personalized treatment options with fewer side effects, potentially improving outcomes for individuals with chronic or recurrent costochondritis.

In conclusion, costochondritis remains a challenging condition to diagnose and manage. However, with a comprehensive understanding of its causes, symptoms, and treatment options, individuals can work closely with their healthcare providers to develop effective management strategies. By staying informed about current research and emerging therapies, patients can take an active role in their care and improve their overall quality of life while living with costochondritis.

Symptoms, Causes, Tests, and Treatment

Costochondritis is an inflammation of the cartilage in the rib cage. It can happen due to infection, injury, and other health conditions.

This condition usually affects the cartilage where the upper ribs attach to the breastbone, also known as the sternum, in an area known as the costosternal joint or costosternal junction.

Chest pain caused by costochondritis can range from mild to severe. Mild cases may only cause your chest to feel slightly tender or some pain when you push on the area.

More severe cases may get worse with certain movements as well as with deep breaths. The condition often goes away within a few weeks or months, but some cases may require treatment.

People with costochondritis often experience chest pain in the upper and middle rib area on either side of the breastbone. This pain can gradually increase over time, or come on suddenly.

Additional symptoms can include:

• pain that becomes worse when lying down
• pain that becomes worse when there’s pressure on your chest, like when you wear a seatbelt
• pain that intensifies with coughing or deep breaths
• pain that increases with physical activity

It’s important to note that symptoms like chest tightness and radiating pain can indicate other conditions, including a heart attack. Seek immediate medical care if you’re experiencing persistent, intense chest pain.

The exact cause of costochondritis in most people is unknown. But conditions that may cause it include:

• trauma to the chest, such as blunt impact from a car accident or fall
• physical strain from activities, such as heavy lifting and strenuous exercise
• certain viruses or respiratory conditions, such as tuberculosis, that can cause joint inflammation
• severe coughing

There’s some research that suggests costochondritis occurs more often in women, especially those who are athletes. You may also be at a higher risk for this condition if you:

• participate in high-impact activities
• recently had a physical trauma or fall that affected the chest area
• have allergies and are frequently exposed to irritants

While there’s no test to diagnose costochondritis, your doctor will most likely ask a series of questions and do a series of tests to determine the source of your chest pain.

Lab tests

Typically, lab tests aren’t needed to diagnose costochondritis, but depending on your personal health history, your doctor may do some tests to see if your chest pain could be due to other issues like pneumonia or coronary heart disease.

X-rays and ECGs

Your doctor may want you to get an X-ray to make sure there’s nothing abnormal going out with your lungs.

If you’re dealing with costochondritis, your X-ray should look normal. They may also recommend an electrocardiogram (ECG) to make sure your heart isn’t the cause of your chest pain.

Many times, diagnosing costochondritis is a matter of eliminating other possible, more serious causes.

See your doctor right away if you have trouble breathing or are feeling intense chest pain.

Always seek immediate emergency care when you have abnormal and debilitating pain in your chest. It can indicate something serious, such as a heart attack.

Getting care as soon as possible limits the possibility of complications, especially if an underlying issue is causing your costochondritis.

Costochondritis can be treated in several ways.

Most cases of costochondritis are treated with over-the-counter medications. If your pain is mild to moderate, your doctor will probably recommend nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) or naproxen (Aleve).

Your doctor may also recommend:

• prescription-strength NSAIDs
• oral steroids or injection of a steroid into the area involved
• transcutaneous electrical nerve stimulation (TENS), which is a mild electric current that is delivered to the area via a small, battery-powered device

Lifestyle changes

Your doctor may tell you to make permanent lifestyle changes if you have persistent or chronic costochondritis.

Some types of exercise can aggravate this condition, including rowing and weightlifting. Manual labor may also have a negative effect.

Your doctor may also recommend:

• rest
• physical therapy
• hot or cold therapy using a heating pad and ice

Normally, treatment of the inflammation and pain causes costochondritis to eventually go away on its own.

If you have chronic costochondritis, the pain may persist or return — even with treatment — when you exercise or engage in certain activities. In these cases, you may need to seek long-term care to make sure that costochondritis doesn’t affect your quality of life and ability to take part in daily activities.

Pains associated with costochondritis can indicate other issues. Chest pain can often mean that you’re having heart or lung issues, so see your doctor right away when you feel pain in your chest to make sure that you’re not having a heart attack or have pneumonia.

The chest pain associated with costochondritis can be a symptom of fibromyalgia. With fibromyalgia, you may experience soreness in your chest in addition to:

• pain throughout your body
• fatigue and inability to rest due to pain
• difficulty focusing or concentrating
• feelings of depression
• headaches

If you experience chest pains along with these other symptoms, talk with your doctor about getting tested for fibromyalgia. Understanding this condition can help you address the symptoms and ensure that it doesn’t interrupt your daily life.

Costochondritis is caused by inflammation and typically presents as chest pain that gets worse with certain movements or pressure. This condition usually isn’t persistent. In many cases, costochondritis goes away on its own.

Mild cases of costochondritis may disappear after a few days. Chronic cases can last for weeks or more, but most cases don’t last any longer than a year.

To lower your chances of developing persistent costochondritis, carry and lift heavy loads properly. Try doing fewer high-impact exercises or manual labor, when possible.

Seek medical attention immediately if you experience chest pain while performing any of these activities.

Symptoms, Causes, Tests, and Treatment

Costochondritis is an inflammation of the cartilage in the rib cage. It can happen due to infection, injury, and other health conditions.

This condition usually affects the cartilage where the upper ribs attach to the breastbone, also known as the sternum, in an area known as the costosternal joint or costosternal junction.

Chest pain caused by costochondritis can range from mild to severe. Mild cases may only cause your chest to feel slightly tender or some pain when you push on the area.

More severe cases may get worse with certain movements as well as with deep breaths. The condition often goes away within a few weeks or months, but some cases may require treatment.

People with costochondritis often experience chest pain in the upper and middle rib area on either side of the breastbone. This pain can gradually increase over time, or come on suddenly.

Additional symptoms can include:

• pain that becomes worse when lying down
• pain that becomes worse when there’s pressure on your chest, like when you wear a seatbelt
• pain that intensifies with coughing or deep breaths
• pain that increases with physical activity

It’s important to note that symptoms like chest tightness and radiating pain can indicate other conditions, including a heart attack. Seek immediate medical care if you’re experiencing persistent, intense chest pain.

The exact cause of costochondritis in most people is unknown. But conditions that may cause it include:

• trauma to the chest, such as blunt impact from a car accident or fall
• physical strain from activities, such as heavy lifting and strenuous exercise
• certain viruses or respiratory conditions, such as tuberculosis, that can cause joint inflammation
• severe coughing

There’s some research that suggests costochondritis occurs more often in women, especially those who are athletes. You may also be at a higher risk for this condition if you:

• participate in high-impact activities
• recently had a physical trauma or fall that affected the chest area
• have allergies and are frequently exposed to irritants

While there’s no test to diagnose costochondritis, your doctor will most likely ask a series of questions and do a series of tests to determine the source of your chest pain.

Lab tests

Typically, lab tests aren’t needed to diagnose costochondritis, but depending on your personal health history, your doctor may do some tests to see if your chest pain could be due to other issues like pneumonia or coronary heart disease.

X-rays and ECGs

Your doctor may want you to get an X-ray to make sure there’s nothing abnormal going out with your lungs.

If you’re dealing with costochondritis, your X-ray should look normal. They may also recommend an electrocardiogram (ECG) to make sure your heart isn’t the cause of your chest pain.

Many times, diagnosing costochondritis is a matter of eliminating other possible, more serious causes.

See your doctor right away if you have trouble breathing or are feeling intense chest pain.

Always seek immediate emergency care when you have abnormal and debilitating pain in your chest. It can indicate something serious, such as a heart attack.

Getting care as soon as possible limits the possibility of complications, especially if an underlying issue is causing your costochondritis.

Costochondritis can be treated in several ways.

Most cases of costochondritis are treated with over-the-counter medications. If your pain is mild to moderate, your doctor will probably recommend nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) or naproxen (Aleve).

Your doctor may also recommend:

• prescription-strength NSAIDs
• oral steroids or injection of a steroid into the area involved
• transcutaneous electrical nerve stimulation (TENS), which is a mild electric current that is delivered to the area via a small, battery-powered device

Lifestyle changes

Your doctor may tell you to make permanent lifestyle changes if you have persistent or chronic costochondritis.

Some types of exercise can aggravate this condition, including rowing and weightlifting. Manual labor may also have a negative effect.

Your doctor may also recommend:

• rest
• physical therapy
• hot or cold therapy using a heating pad and ice

Normally, treatment of the inflammation and pain causes costochondritis to eventually go away on its own.

If you have chronic costochondritis, the pain may persist or return — even with treatment — when you exercise or engage in certain activities. In these cases, you may need to seek long-term care to make sure that costochondritis doesn’t affect your quality of life and ability to take part in daily activities.

Pains associated with costochondritis can indicate other issues. Chest pain can often mean that you’re having heart or lung issues, so see your doctor right away when you feel pain in your chest to make sure that you’re not having a heart attack or have pneumonia.

The chest pain associated with costochondritis can be a symptom of fibromyalgia. With fibromyalgia, you may experience soreness in your chest in addition to:

• pain throughout your body
• fatigue and inability to rest due to pain
• difficulty focusing or concentrating
• feelings of depression
• headaches

If you experience chest pains along with these other symptoms, talk with your doctor about getting tested for fibromyalgia. Understanding this condition can help you address the symptoms and ensure that it doesn’t interrupt your daily life.

Costochondritis is caused by inflammation and typically presents as chest pain that gets worse with certain movements or pressure. This condition usually isn’t persistent. In many cases, costochondritis goes away on its own.

Mild cases of costochondritis may disappear after a few days. Chronic cases can last for weeks or more, but most cases don’t last any longer than a year.

To lower your chances of developing persistent costochondritis, carry and lift heavy loads properly. Try doing fewer high-impact exercises or manual labor, when possible.

Seek medical attention immediately if you experience chest pain while performing any of these activities.

causes of occurrence, in which diseases it occurs, diagnosis and methods of treatment

Heart failure

Renal failure

Cirrhosis

Myxedema

Edema

Cyanosis

Shortness of breath

29210

April 28

Hydrothorax: causes of occurrence, in which diseases it occurs, diagnosis and methods of treatment.

Definition

Hydrothorax is a pathological condition characterized by the accumulation of excess fluid in the pleural cavity. The term “hydrothorax” consists of two Greek roots: “hydor” – water, “thorax” – chest, which literally means “chest dropsy”.

Human lung is covered with two sheets of serous membrane – pleura. One of them densely covers the surface of the lungs and their vessels. The second is tightly adjacent to the ribs and organs that are located between the lungs (heart, esophagus, lymph nodes, etc.).

The pleural cavity is a narrow space between the layers of the pleura.

The main task of the pleura is to participate in the act of breathing. Normally, the pleural cavity contains a small amount of serous fluid, due to which the sheets easily slide relative to each other, protecting the organs from excessive friction and injury during breathing. If the level of fluid between the layers of the pleura exceeds the physiological norm, then they speak of the presence of hydrothorax, which is accompanied by characteristic symptoms of respiratory failure (shortness of breath, heaviness in the chest, cyanosis of the nasolabial triangle).

Pleural effusion is produced by the capillaries of the intercostal arteries, and excess fluid is removed by the lymphatic system.

The accumulation of fluid occurs only in the case of an increase in its flow into the pleural cavity or blocking its reverse outflow.

With hydrothorax, the accumulating fluid is non-inflammatory in nature (transudate), in contrast to exudative pleurisy, in which the effusion is of inflammatory origin (exudate). Transudate is a clear colorless or slightly yellowish liquid, has an alkaline reaction, the protein level in it is not more than 3%. The amount of transudate is very variable and can reach several liters.

All the inconveniences and problems that hydrothorax causes are mechanical in nature. Accumulating in the pleural cavity, the fluid begins to put pressure on the lungs and mediastinal organs. A large volume of fluid in the pleural cavity can provoke a serious complication – acute respiratory failure, which threatens the life of the patient. In addition, there is a high risk of displacement of the mediastinal organs, circulatory disorders and the development of severe cardiac pathology.

In some cases, secondary infection may occur with the development of a purulent inflammatory process in the pleural cavity (pleural empyema).

Varieties of hydrothorax

The classification of hydrothorax is based on the volume and location of the fluid:

• small hydrothorax – the fluid is located within the costophrenic sinus;
• medium hydrothorax – accumulation of fluid is observed from the angle to the level of the middle of the scapula;
• large hydrothorax – fluid level above the middle of the scapula.

There are also right-sided and left-sided hydrothorax, but in most cases, hydrothorax covers both pleural cavities. Bilateral effusions can be symmetrical or asymmetrical.

Based on the amount of transudate, hydrothorax is distinguished:

• encysted – limited by adhesions or other tissues from a larger area of ​​the pleural fissure, can be located on any surface of the pleura;
• partial;
• total.

Possible causes of hydrothorax

Hydrothorax is not an independent disease, that is, it inevitably develops against the background of another disease. The cause of its occurrence is always a chronic or complicated disease of the internal organs, as well as a side effect of treatment. The main causes of hydrothorax include:

• violations of the permeability of the vascular wall;
• lymphatic drainage disorders;
• electrolyte metabolism disorders;
• increase in aldosterone production;
• increase in pressure in the vascular system of the pulmonary circulation;
• physiologically low pressure in the pleural cavity.

Diseases and pathological conditions leading to hydrothorax:

Chronic heart failure , which may be associated with ischemic disease, heart disease, constrictive pericarditis, myocarditis, chronic obstructive pulmonary disease.

The accumulation of transudate in the interpleural space occurs due to venous congestion in the systemic circulation.

Renal failure associated with nephrotic syndrome . It is a consequence of kidney diseases of a different nature, which involve damage to the renal glomeruli: glomerulonephritis, amyloidosis of the kidneys, collagenoses, toxic nephropathy, etc.

Against the background of hypoproteinemia and hypoalbuminemia, generalized edema, hydropericardium, hydrothorax, and ascites develop.

Nutritional dystrophy associated with inferiority or malnutrition (severe form of protein-energy malnutrition). In this case, effusion into the pleural cavity is directly related to a deficiency of vitamins B and C, a decrease in lymph outflow.

Cirrhosis of the liver . Hydrothorax develops in 5-10% of patients in the terminal phase of liver cirrhosis, which indicates the presence of congestion in the blood system. It is due to hypoalbuminemia, portal hypertension, and concomitant ascites. It is a consequence of the ingress of ascitic fluid from the abdominal cavity into the pleural cavity through the diaphragm.

Peritoneal dialysis . This procedure involves the introduction of a large volume of fluid into the abdominal cavity, and then its removal. Hydrothorax occurs due to the movement of dialysis fluid from the abdominal cavity into the pleural cavity. At the same time, right-sided hydrothorax develops in 90% of cases.

Tumors . In oncological diseases, recurrent hydrothorax is often observed, the cause of which can be not only the malignant neoplasm itself, but also its treatment with radiation or chemotherapy. Another possible reason is a malfunction of the lymphatic system due to the defeat of the lymph nodes by metastases or the germination of a cancerous tumor. Most often, the accumulation of fluid in the lungs occurs with cancer of the lung, breast, ovary, stomach, body and cervix, with melanomas, lymphomas, sarcomas, leukemia. With a malignant tumor of the pleura (mesothelioma), the permeability of the vascular wall of the capillaries increases. Fluid from the blood actively enters the lungs, and its pumping out by the lymphatic system, on the contrary, worsens. As a result, stagnation and accumulation of fluid occurs.

Myxedema – lack of thyroid hormones . The mechanism of transudate formation in severe hypothyroidism is unknown. It is assumed that this is due to stagnation of the lymph due to a decrease in the production of thyroid hormones.

Pulmonary embolism . The effusion can be either a transudate or an exudate. The first is characteristic of acute cor pulmonale, the second – for pulmonary infarction.

Fetal hydrothorax during pregnancy . A pleural effusion in a fetus can be caused by genetic problems; infections and malformations, especially of the heart or lungs; situations when, with a Rh conflict, the work of the circulatory system is disrupted. In newborns, hydrothorax can occur when the umbilical cord is entwined or birth trauma.

Which doctors to contact for hydrothorax

The presence of pleural effusion is indicated by the physical examination data and the patient’s current complaints.

X-ray image of patient’s lung showing pleural effusion (yellow arrow)

therapist,
general practitioner or
pulmonologist. Further management of patients is carried out by a specialized specialist:
cardiologist, hepatologist, nephrologist,
endocrinologist. In the hospital, the patient is observed by a thoracic surgeon.

Diagnosis and examination of hydrothorax

Symptoms of hydrothorax are the result of squeezing the lungs with accumulated fluid. Patients are concerned about the feeling of heaviness, pressure in the chest, dry cough, shortness of breath. If a large amount of transudate accumulates in the pleural cavity, the outflow of blood from the jugular veins becomes difficult. Then their swelling becomes noticeable. There is a total swelling of tissues, accumulation of fluid in the abdominal cavity, sometimes in the pericardium. Characteristic objective signs are tachypnea, asymmetry of the chest, limited mobility of the affected side during breathing, cyanosis of the skin.

The doctor detects the presence of excess fluid in the pleural cavity at the initial stages of the examination. The specialist examines the chest, conducts percussion (percussion) and auscultation (listening with a stethoscope).

The following diagnostic algorithm is used to confirm hydrothorax:

• Ultrasound examination of the pleural cavities makes it possible to detect the presence of even a minimal amount of effusion in the chest cavity, to determine its amount with high accuracy. In addition, ultrasound is used for labeling and control during pleural puncture.

Ultrasound of the pleural cavity

Examination of the pleural cavity for the diagnosis of various pathologies of the lungs, including traumatic injuries of the pleura.

RUB 1,890

Sign up

Chest x-ray provides detailed information about the pathological condition. The radiological sign of pleural effusion is a homogeneous darkening of the lung fields with an oblique upper border of the fluid.

Plain chest x-ray

X-ray examination of the structure of the lungs to diagnose various pathologies.

RUB 2,440

Sign up

CT of chest and mediastinum

A study that allows you to obtain data on the state of the organs of the chest and mediastinum.

RUB 5,490

Sign up

Diagnostic puncture is performed to determine the nature of excess fluid in the respiratory organs, its further analysis and removal from the pleural cavities.

Examination of transudates, exudates, secretions

Material for research:

smears prepared in the laboratory from the sediment of transudates, exudates, secrets, excreta and urine;

smears prepared from …

Up to 2 working days

Available with home visit

RUB 1,030

Add to cart

Additional studies are carried out in order to determine the cause of the appearance of pathological contents (trauma, infection, tumor process, etc. ). It is advisable to perform an ultrasound examination of the abdominal organs and kidneys, mediastinum, thyroid gland.

Comprehensive ultrasound examination of the abdominal organs (liver, gallbladder, pancreas, spleen)

Scanning of the internal organs of the abdominal cavity to assess its functional state and the presence of pathology.

RUB 3,090

Sign up

Comprehensive ultrasound examination of the urinary system (kidneys, ureters, bladder)

Comprehensive ultrasound scan of the urinary system, which allows to detect pathology at an early stage of development.

RUB 2,990

Sign up

Ultrasound of the thyroid gland, parathyroid glands and regional lymph nodes

Examination of the thyroid and parathyroid glands, which allows to assess their structure, as well as to detect pathological changes in these organs and regional lymph nodes. ..

2,040 rubles

Sign up

If heart failure is suspected, echocardiography, electrocardiography is performed.

Echocardiography

Examination to assess functional and organic changes in the heart, its contractility, as well as the condition of the valvular apparatus.

RUB 4,190

Sign up

ECG in 5 minutes

Examination of the functionality of the heart – fast, painless and informative.

RUB 1,790

Sign up

Laboratory diagnostic methods may show:

• urinalysis;

General urinalysis (Urine analysis with sediment microscopy)

Method of determination

Determination of physical and chemical parameters is carried out on an automatic analyzer using the “dry chemistry” method.

Hardware microscope…

Up to 1 business day

Available with house call

410 RUB

Add to cart

Blood biochemistry: basic profile

Up to 1 business day

Available with home visit

2 565 RUB

Add to cart

Thyroid gland: extended examination

Up to 1 business day

Available with home visit

RUB 3,185

Add to cart

What to do about hydrothorax

The occurrence of hydrothorax is often asymptomatic, but the gradual accumulation of transudate signals itself with the following symptoms:

• feeling of heaviness in the chest;
• shortness of breath;
• breathing is facilitated in a sitting position;
• peripheral edema.

The presence of prerequisites for the development of hydrothorax and the combination of these symptoms are the reason for urgent medical attention.

With hydrothorax of the lungs, the patient is subject to hospitalization in the hospital in the department of thoracic surgery, since in many cases pleural hydrothorax is a symptom of another disease, so the treatment is aimed at eliminating the underlying disease.

Treatment of hydrothorax

Treatment of hydrothorax consists of conservative therapy aimed at the underlying disease, and pleural puncture to evacuate excess fluid, if necessary.

Small hydrothorax does not require special treatment. The fluid resolves on its own with successful treatment of the underlying disease.

Massive volumes of effusion require immediate intervention. The complete removal of fluid is called thoracentesis. The procedure is performed in the operating room by a thoracic surgeon under local anesthesia. A thin needle is inserted into the gap between the lower pairs of ribs, through which the exudate is evacuated. The intervention is carried out under ultrasound control. In the future, a catheter (a long narrow tube) and a special bag for the continuous outflow of excess fluid remain at the puncture site. Treatment of pulmonary hydrothorax with thoracentesis improves the patient’s condition, reduces shortness of breath.

Pleurodesis is the introduction of sclerosing agents into the pleural cavity, which stick together the thoracic and parietal pleura. After that, the liquid becomes nowhere to accumulate. Pleurodesis is usually performed after the effusion has been drained (thoracentesis). In oncological diseases, chemotherapeutic agents are used for pleurodesis, which have a cytostatic effect and at the same time glue the pleural petals.

Removal of the pleura in oncological diseases is usually performed laparoscopically.

In order to reduce respiratory disorders, unloading punctures or permanent drainage of the pleural cavity are performed.

If the cause of fluid accumulation was not an oncological disease, drug therapy with diuretics (diuretics), anti-inflammatory drugs, antibiotics, bronchodilators, expectorants and other drugs is used according to indications.

In heart failure, which caused hydrothorax, the main task is to reduce the load on the heart and normalize its contractile function, and therefore use cardiac glycosides and β-adrenergic stimulants, vasodilators, ACE inhibitors, diuretics.

Therapy of nephrotic syndrome requires the appointment of antihypertensive drugs that reduce the loss of proteins in the urine (ACE inhibitors), intravenous infusions of albumin, immunosuppressants, potassium-sparing diuretics, anticoagulants.

For hepatic hydrothorax, hepatoprotectors, preventive antibiotic therapy with third-generation cephalosporins are recommended.

Myxedema is treated with thyroid hormone replacement therapy.

In all cases of hydrothorax, a therapeutic diet is recommended (table No. 7, No. 10). Exclude salt from the diet, limit the intake of fluids and protein foods, enrich the diet with potassium-containing foods (dried fruits, vegetables). Arrange special fasting days.

Sources:

1. Chuchalin, A. G. Pulmonology. National leadership. Brief edition / ed. A. G. Chuchalina. – M.: GEOTAR-Media, 2018. – 800 p.
2. Chuklin S.N. Hydrothorax in patients with liver cirrhosis (hepatic hydrothorax) // Medicine and Pharmacy. Gastroenterology. – 2007 (226).
3. Clinical and radiological syndromes of the respiratory system / Ryabova L.V., Kolyadich M.I.; ed. I.I. Shaposhnik. — 2015.
4. Big Medical Encyclopedia (BME), edited by Petrovsky B.V., 3rd edition, volume 5.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.