Differential Diagnosis for Bilateral Pleural Effusion in Severe Mitral Regurgitation
- Single Most Likely Diagnosis
- Congestive Heart Failure (CHF): This is the most likely diagnosis given the context of severe mitral regurgitation, as CHF often leads to fluid overload and subsequent pleural effusions.
- Other Likely Diagnoses
- Pulmonary Embolism: Although less common than CHF in this context, pulmonary embolism can cause pleural effusions and is a consideration in patients with severe mitral regurgitation who may have increased risk of thromboembolic events.
- Nephrotic Syndrome: Severe proteinuria can lead to hypoalbuminemia, which in turn can cause fluid shifts and pleural effusions. This could be a contributing factor in some cases.
- Do Not Miss Diagnoses
- Malignancy (e.g., Lung Cancer, Lymphoma): Although less likely, malignancies can cause pleural effusions and are critical to diagnose due to their significant impact on prognosis and treatment.
- Tuberculosis: Especially in endemic areas, tuberculosis can cause pleural effusions and must be considered to ensure appropriate treatment.
- Pulmonary Arterial Hypertension: This condition can complicate severe mitral regurgitation and lead to right heart failure, which may cause pleural effusions.
- Rare Diagnoses
- Amyloidosis: A rare condition that can affect the heart and lead to restrictive cardiomyopathy, potentially causing pleural effusions.
- Sarcoidosis: Although rare, sarcoidosis can involve the lungs and heart, leading to pleural effusions in the context of severe mitral regurgitation.
- Connective Tissue Diseases (e.g., Rheumatoid Arthritis, Systemic Lupus Erythematosus): These conditions can cause pleural effusions and, although rare, should be considered in the differential diagnosis.