Diagnostic issues in cardiac failure : A febrile pleural effusion in a patient with LV dysfunction .
Is it a transudate or exudate ? How to confirm the pleural effusion is primarily cardiac failure related ?
When the classical protein criteria is inadequate or prone for errors
Try this more specific marker within the pleural fluid
N-Terminal Brain naruretic peptide
Pleural fluid NT-proBNP is very useful in establishing the diagnosis of HF-associated effusions, and it confirms this diagnosis . The measurement of NT-proBNP rather than serum to pleural protein gradient is recommended for identifying mislabeled cardiac transudates.
Dr.S.Venkatesan MD 