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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 63757
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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Patient is over 80 years old .In x ray report it was

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patient is over 80 years old .In x ray report it was written " a moderately large right pleural effusion has increased in size since prior with opacification of the right meddle and lower lobe .There is also nodular pleural thickening at the peripher of the right upper lobe. asmall left pleural effusion is seen at the the costophrenic angle. Mild vascular congestion is seen without interstitial or alveolar edema" Please suggest treatment and patient is taking 20 mg lasix and other heart medicines
Submitted: 10 months ago.
Category: Medical
Expert:  Dr. David replied 10 months ago.

This is Dr. David

with more pleural effusion, this can be a sign of congestive heart failure when too much fluid backs up in the lung

you need to talk his doctors about increasing the dose of lasix to help get rid of fluid out of the lungs.

he might need a chest CT scan which an tell more about the pleural nodular thickening.

if he is coughing, he could have a pneumonia and might need a course of antibiotic to help clear up the pneumonia.

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Expert:  Dr. Thomas, MD replied 10 months ago.

Hello

The definitive help to diagnose an effusion, and distinguish between a transudate and an exudate, and thus help distinguish infection from heart disease, is a throacentesis, for diagnostic and sometimes therapeutic purposes.

This fluid drawn from the thoracic space is sent to the lab for analysis.

One can keep guessing and treating, but this has already happened, and it is time for a proper diagnosis.

Any good internal medicine doctor, or pulmonologist can do this, which would involve a brief stay in observation in the hospital.

Talk to his doctors about this possibility.

I am a double board certified US doctor [internal medicine and integrative medicine]. Please click a positive rating so that Dr. Thomas [this screen, see top] gets paid.

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