Does CHF Cause Exudative Pleural Effusions?

In these CHF patients, most exudative effusions had causes other than heart failure.

According to conventional teaching, congestive heart failure causes transudative pleural effusions; nevertheless, we occasionally encounter CHF patients with exudative effusions. Can we assume that CHF is responsible for the exudates in these cases?

In a retrospective study, Oklahoma researchers identified 770 hospitalized patients with CHF and pleural effusions. Thoracenteses were performed in 175 patients: 86 had transudates, and 89 had exudates (classified according to Light's criteria). During hospitalization, non-CHF explanations (e.g., infection, cancer) were found for 59 of the 89 exudates. Among the remaining 30 cases, non-CHF causes became evident in 7 patients during follow-up. Thus, 23 patients had exudative effusions with no iden…

Reviewing Author

Allan S. Brett, MD