Pleural effusions in patients with congestive heart failure are typically bilateral. However, a unilateral pleural effusion is more commonly seen on the right side.

WHY??? Although multiple theories attempt to explain the right-sided preponderance of pleural effusions, to date, no mechanism has been universally accepted or experimentally proven.

REFERENCES

  1. Woodring JH. Distribution of pleural effusion in congestive heart failure: what is atypical? South Med J. 2005 May;98(5):518-23.
  2. Natanzon A, Kronzon I. Pericardial and pleural effusions in congestive heart failure-anatomical, pathophysiologic, and clinical considerations. Am J Med Sci. 2009 Sep;338(3):211-6. doi: 10.1097/MAJ.0b013e3181a3936f.
  3. Porcel JM. Pleural effusions from congestive heart failure. Semin Respir Crit Care Med. 2010 Dec;31(6):689-97. doi: 10.1055/s-0030-1269828. Epub 2011 Jan 6.

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