Analysis of Pleural Effusions in Acute Pulmonary Embolism: Radiological and Pleural Fluid Insights

Abstract

Introduction: Pleural effusions in the context of acute pulmonary embolism (PE) are garnering increased recognition for their clinical significance. Acute PE, a serious medical condition marked by the sudden blockage of pulmonary arteries due to blood clots, presents with a wide array of symptoms and poses significant diagnostic challenges. These effusions in PE patients are not merely incidental findings but may offer valuable insights into the severity, pathophysiological mechanisms, and potential outcomes of the disease. Their presence, characteristics, and composition could provide crucial information for the diagnosis, management, and prognostic evaluation of PE, thus representing an important facet in understanding and treating this complex condition. Objective: This retrospective cross-sectional study examines the pleural effusions' radiological features in acute PE and assesses the fluid's chemical composition. Methodology: At Khyber Teaching Hospital, Peshawar, 78 patients who had been diagnosed with acute PE underwent a retrospective cross-sectional design study during the period from November 2020 and October 2021. To classify pleural effusions and evaluate their components, radiological information from computed tomography pulmonary angiography (CTPA) scans and pleural fluid analysis was employed. Results: Among the study cases, 68% of patients with acute PE had pleural effusions, which were often minor to moderate in size (47% and 34%, respectively). Among the radiological abnormalities that were related were pleural thickening (7%), atelectasis (15%), and pulmonary infarcts (26%). A study of the pleural fluid revealed higher levels of several proteins, coagulation parameters, and inflammatory markers. Pleural effusions had an 81% diagnostic accuracy in distinguishing PE from other diseases, and there was a relationship between effusion size and biomarkers and clinical outcomes. Conclusion: Understanding pleural features improves acute PE diagnosis and treatment strategies. Pleural effusions offer prognostic and diagnostic information that can be used to improve patient treatment and outcomes.