Heart failure with a pleural effusion is typically associated with which type of effusion?

• A. Transudative
• B. Exudative
• C. Empyema
• D. Chylous

Answer: (A)

The key idea is how pleural effusions are classified. In heart failure, elevated hydrostatic pressure in the capillaries pushes fluid into the pleural space. This fluid is mainly a plasma filtrate with little protein or LDH, so it fits the profile of a transudate. Transudative effusions arise from systemic factors that alter pressures or oncotic balance (like heart failure, cirrhosis, nephrotic syndrome), whereas exudates come from local inflammation or infection that increases vascular permeability and raises protein and LDH in the pleural fluid. So, the typical pleural effusion seen with heart failure is transudative.