21. Transudative pleural effusions occur in congestive heart failure ( CHF ), cirrhosis or nephrotic syndrome. 22. Sometimes, a chest x-ray is used to detect metastases in the chest or pleural effusion . 23. These may include management for shortness of breath due to recurrent, symptomatic malignant pleural effusions . 24. It is one of various kinds of pleural effusion . 25. In countries where tuberculosis is common, this is also a common cause of pleural effusions . 26. The most common causes of pleural effusions are cancer, congestive heart failure, pneumonia, and recent surgery. 27. The ER workup reveals a bloody pleural effusion . 28. Another indicator may be the presence of a pleural effusion , which can be noted on auscultation. 29. In medicine, talc is used as a pleurodesis agent to prevent recurrent pleural effusion or pneumothorax. 30. In spite of all the diagnostic tests available today, many pleural effusions remain idiopathic in origin.