Vasotec, generically known as enalapril, is a medication to treat hypertension and congestive heart failure. By helping the blood vessels relax, Vasotec reduces the amount of work the heart does and lowers your blood pressure. Unfortunately, there is a link between Vasotec and pleural effusion.
What is Pleural Effusion?
Healthy lungs have a thin layer of fluid surrounding the pleura, which are the membranes that line the outside of the lungs and the inside of the chest cavity. The small amount of fluid serves as lubrication to help ease breathing. It allows the lungs to expand and contract more easily. Pleural effusion happens when too much fluid collects between the chest cavity and the lungs. Depending on the cause, the fluid can be transudate (a watery fluid), exudate (a protein-rich fluid), lymphatic (a milky fluid), pus or blood. Pleural effusion is sometimes called fluid in the chest, pleural fluid or fluid around the lungs.
Pleural effusion can be caused by certain medications such as Vasotec. Vasotec is found in a group of medications known as angiotensin-converting enzyme (ACE) inhibitors. ACE inhibitors are prescribed to patients suffering from hypertension or congestive heart failure. ACE inhibitors signal the kidneys to produce a protein called renin. Angiotensin production responds to the increase of renin in the body. These proteins trigger the adrenal gland to produce aldosterone. Aldosterone is a hormone that causes kidneys to retain sodium, which leads to water retention. Water retention triggers health problems such as pleural effusion.
Vasotec and pleural effusion share some of the same side effects and symptoms. The most common symptoms of pleural effusion as a side effect of Vasotec are chest pain and shortness of breath. Breathing may become more difficult when lying down. Some people suffering from drug-induced pleural effusion experience continuous chest pain. Other people only experience chest pain when breathing deeply or coughing. The pain may be located in the chest wall over the inflammation, in the upper abdominal region, neck or shoulders. Other symptoms of pleural effusion include coughing, hiccups or a fever. It is possible to suffer from pleural effusion and show no symptoms.
Doctors generally use a physical examination and medical record to diagnose pleural effusion. Their initial diagnosis is confirmed using a chest x-ray, chest CT scan, thoracic CT or chest ultrasound. In some cases, a doctor will insert a needle between the ribs and draw out a sample of the collecting fluid. The fluid is examined under a microscope to determine if it is caused by pleural effusion.
The buildup of fluid must be removed from the chest cavity to treat pleural effusion. A drainage tube may be inserted into the area to relieve the buildup and make breathing easier. The tube may be left in for a long time to drain sufficient fluid from the chest. Some patients are prescribed water pills. Mild cases of plural effusion may not need fluid removal. Once the fluid has been removed from the chest cavity, the doctor must prevent the condition from reoccurring. To do this, the cause of the fluid buildup must be addressed. If the pleural effusion is a side effect of Vasotec, the doctor may prescribe a different medication or lifestyle change to correct the problem.
WebMD: Vasotec Oral
PubMed Health: Enalapril
MedlinePlus: Pleural Effusion
Cleveland Clinic: Pleural Effusion - Heart and Vascular Institute Overview
Merck Manuals: Pleural Effusion
EMedTV: Vasotec Side Effects