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Lung diseases

Fluid in lungs

05/08/2006

Question:

My father is 68, history of high blood pressure (under control with medication), had shingles a year and a half ago and pneumonia a while back. Has suffered from a lack of energy, breathlessness and, at night, a feeling of draining from his nasal passages into his lungs for the past month (says that recently his feet have been slightly swollen). Just found out from an x-ray that he has fluid buildup in his lungs and is to get a "lung tap" soon. Several questions: Can a man who smoked pipes for about 15 years approximately 20 years ago get lung cancer? 2) What diagnosis can be made with a chest x-ray (his cardiologist sent him for one after hearing the fluid in his chest)? 3) What does a lung tap entail? 4)Is there any way this does not have to be congestive heart failure or lung cancer?

Answer:

It appears that your father has congestive heart failure which is a reduction in heart function that causes blood and fluid to back up in the lungs and dependent parts of the body-causing swelling or edema of the feet and ankles.  Treatment is usually various medications to improve heart function and help the body get rid of excess fluid.

A pleural effusion or collection of fluid around the lungs can be diagnosed by chest xray.

Certainly smoking a pipe is a risk factor for lung as well as upper airway cancers.  There is usually a lag period of between 10-20 years between smoking and the diagnosis of lung cancer.

A lung "tap" or thoracentesis is the insertion of a needle or catheter into the space around the lung to remove fluid.  This procedure is done as an outpatient with minimal local anesthesia.  The fluid is sent to the lab to be analyzed for various chemistries, infections, and cytology-examination for cancer cells.  From those results, your father's physician should be able to tell him the cause of the fluid accumulation and how best to treat it.

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Response by:

Ralph   Panos, MD Ralph Panos, MD
Associate Professor
College of Medicine
University of Cincinnati