Causes Make an Appointment Refer a Patient Ask a Question Reviewed by Ellen Volker, MD, MSPH (May 01, 2019) Identifying the root cause of your pleural effusion determines the treatment you need The most common cause of pleural effusion is congestive heart failure (CHF). This means the heart has difficulty pumping blood throughout the body. Congestive heart failure (CHF) is also called cardiac failure, left-sided heart failure and right-sided heart failure. CHF doesn't mean that your heart has stopped or is going to stop. It means that your heart can't pump the blood that your body needs to function. CHF may affect the left side,the right side or both sides of the heart. Congestive heart failure means that your heart is weak. CHF can be caused by coronary artery disease, high blood pressure and diabetes. Other causes of fluid in the lungs include: Pulmonary embolism caused by blood clots Chest surgery or trauma Liver disease (cirrhosis) Cancer, including lung cancer, breast cancer and lymphoma Autoimmune diseases, such as rheumatoid arthritis or lupus Lung disease including sarcoidosis, asbestosis and mesothelioma Kidney disease Infection Tuberculosis Pneumonia Some medications and cancer treatments, including radiation and chemotherapy, can also cause pleural effusion. Pleurisy can cause pleural effusion. Viral infections are the most common cause of pleurisy. Other causes of pleurisy include: Bacterial or fungal infections Autoimmune diseases such as rheumatoid arthritis or lupus Chest trauma Cancer Certain medications Symptoms Clinical Trials For more than 100 years, National Jewish Health has been committed to finding new treatments and cures for diseases. Search our clinical trials.