Differential Diagnosis for Bilateral Pleural Effusion in Rheumatic Heart Disease (RHD)
- Single most likely diagnosis
- Congestive heart failure: This is the most likely diagnosis given the context of RHD, as congestive heart failure is a common complication of RHD and can lead to bilateral pleural effusions due to fluid overload.
- Other Likely diagnoses
- Pulmonary embolism: Although less common, pulmonary embolism can occur in patients with RHD, especially if they have atrial fibrillation, and can cause bilateral pleural effusions.
- Pericardial effusion: RHD can also lead to pericardial effusion, which can cause bilateral pleural effusions due to the close proximity of the pericardial and pleural spaces.
- Do Not Miss diagnoses
- Malignancy (e.g., metastatic cancer): Although less likely, malignancy can cause bilateral pleural effusions and is a diagnosis that should not be missed due to its significant implications for treatment and prognosis.
- Tuberculosis: In regions where tuberculosis is common, it should be considered as a potential cause of bilateral pleural effusions, especially if the patient has risk factors or symptoms suggestive of tuberculosis.
- Rare diagnoses
- Chylothorax: A rare condition characterized by the accumulation of chyle in the pleural space, which can occur in patients with RHD due to obstruction of the thoracic duct.
- Amyloidosis: A rare condition characterized by the deposition of amyloid proteins in various tissues, including the lungs, which can cause bilateral pleural effusions in patients with RHD.