BEWARE THE LEFT-SIDED EFFUSION

A left-sided pleural effusion is an infrequent clinical occurrence com pared with bilateral or right-sided effusions. After coronary bypass s urgery, a patient presented with dyspnea and an enlarging left pleural effusion erroneously attributed to congestive heart failure and refra ctory to medical management. Thoracentesis generated a clinical surpri se, allowed specific therapy, and produced evidence for a rarely repor ted complication of coronary artery bypass grafting. The management of chylothorax and the differential diagnosis of left-sided pleural effu sions are reviewed.