A 51-year-old female with a history of metastatic ovarian cancer on chemotherapy, malignant pleural effusions requiring repeat thoracentesis, and pulmonary embolism presented to the Emergency Department with worsening shortness of breath and dry cough. Upon arrival, she was hypoxic with an oxygen saturation level of 75% on room air. She was tachycardic, tachypneic, and her blood pressure was 125/56 mmHg. Labs revealed only a mild anemia (Hgb: 10.2). It was determined that her symptoms were secondary to recurrent right-sided malignant pleural effusions. Her presenting chest X-ray is pictured above (Image 1: Author’s own image).
Because of the patient’s debilitating symptomatology, a right-sided bedside thoracentesis was performed. 1.5 L of thin, dark brown fluid was removed and after the procedure, the patient stated she felt much better. Repeat vital signs after thoracentesis revealed: HR 105 bpm, RR 18 rpm, O2 saturation of 98% on room air. Blood pressure remained stable. A repeat chest x-ray was performed:
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