Fluid in the Lungs – Causes and Treatment

Fluid in the lungs is a broad term to describe two possible conditions that may give characteristic symptoms, like a bubbling sound in the lungs (rales) when breathing. The fluid accumulation may be inside the lung (pulmonary edema) or outside the lung (pleural effusion), in the space between the lung and chest wall. The term “fluid in the lungs” is also used to refer to mucus inside the lungs. Mucus or phlegm is a thick, sticky secretion while “lung water” is a thin fluid. Other fluid accumulation may be the result of  blood or pus.


The lungs are located in the thorax (chest) and lies on either side of the heart. Air travels through the air passages, which includes the nose, pharynx (throat), trachea (air pipe) and bronchi. The lung tissue is made of small air sacs, known as alveoli, which is thin and surrounded by blood capillaries. The structure of the respiratory system allows for an exchange of gases so that essential oxygen is taken into the body and waste products, along with gases, are excreted through the exhaled air. The lung is enclosed in an air tight pleural cavity, with a small pleural space separating the lung from the chest wall. This cavity is lined by the pleural lining, which also produces a little pleural fluid to reduce friction between the chest wall and lungs during breathing.

Fluid Inside the Lungs

The most common cause for fluid inside the lungs is mucus or phlegm, which is produced by the lining of the respiratory tract. The respiratory tract is lined with a mucus membrane, which is a specialized tissue that produce smucus. This mucus lubricates the lining, which may dry out due to the air moving in and out of the passages, as well as to trap any dust or microorganisms in the air. However in certain conditions, the mucus membranes of the air passages may produce excessive amounts of mucus and this may slowly ‘sink’ lower down the air passages until it settles in the lungs. The cough reflex or even spontaneous coughing will usually propel most mucus out through the mouth (sputum), however in cases of excessive mucus production, obstructive airway disease or diminished coughing, the mucus build up will quickly settle in the lungs.

“Lung water” or water in the lungs usually results from interstitial fluid or blood plasma and may be an indication of a more serious underlying disorder, usually cardiovascular conditions. This fluid inside the lung is known as pulmonary edema and may be accompanied by a shortness of breath or difficulty breathing (dyspnea), a feeling of suffocation, anxiety and restlessness. Abnormal breathing sounds are also present, particularly crackling. Pulmonary edema may be considered a medical emergency and immediate medical intervention is required.

Blood may also fill inside the lungs but this usually occurs as a result of severe trauma and the cause is clearly evident, like in a gunshot or stab wound. In most trauma cases where blood can fill into the lungs, the lungs collapse and the blood accumulates around the lungs in the pleural space (hemothorax). Infections like tuberculosis (TB) or lung cancer may also cause blood accumulation inside the lungs. Depending on the severity of the trauma, blood inside the lungs will cause drowning and requires immediate medical attention. Pus may also occur inside the lung due to a lung abscess and also requires immediate urgent medical attention.

Causes of Fluid Inside the Lungs

  • Bronchitis is the most common cause of mucus in the lungs and is often characterized by persistent coughing. This respiratory condition may develop after the common ‘cold’ or flu (seasonal influenza) , often a s a result of a secondary bacterial infection but may also be chronic and non-infectious as in the case of  smokers.
  • Infections may cause hypersecretion of mucus in the respiratory tract and/or pulmonary edema and this includes viral (example – H1N1 swine flu, SARS – Sudden Acute Respiratory Syndrome), bacteria (example  – tuberculosis, streptococcal or pneumococcal pneumonia), fungi (example – histoplasmosis, aspergillosis, candidiasis) and parasitic  (example – toxoplasmosis) infectious agents.
  • Pneumonia may also result in “lung water” or fluid with a thinner viscosity. This may arise only at the affected lobe of the lung due to inflammation of the lung tissue. Pneumonia is not only caused by infections but may be due to gastric contents that are aspirated from the stomach into the lungs.
  • Allergies often result in increased mucus production, however, in certain acute cases, there may be pulmonary edema. Post nasal drip may often lead to mucus collection within the lungs and allergies may cause inflammation of the bronchioles and mucus in the chest of asthmatics.
  • Near drowning results in fluid in the lungs and even if all the fluid is drained from the lungs, it is important to monitor the patient in hospital to prevent dry drowning.
  • Many cardiovascular conditions will possibly lead to pulmonary edema and this includes hypertension (high blood pressure), myocardial infarction (heart attack), heart valve disease or cardiomyopathy (damaged heart muscle).
  • Renal failure may cause pulmonary edema as the kidneys are unable to filter out toxins in the blood.
  • Smoke inhalation may cause severe inflammation of the lung tissue, which results in fluid accumulation in the lungs.
  • Lymphatic insufficiency result in inadequate drainage of lymph fluid.
  • Drug side effects may result in pulmonary edema and this includes OTC (over-the-counter) or prescription drugs, narcotics or anesthetics. This may also occur after usage of the drug, when the effects of the drug appear to have worn off.
  • Inhaled, ingested or injected toxins or poisons may increase the permeability of capillary walls, thereby leading to pulmonary edema. Some toxins may also increase mucus production in the lining of the lungs.
  • Autoimmune diseases like sarcoidosis may cause fluid in the lungs due to the inflammation of the lung tissue.
  • Shortage of oxygen due to high altitudes, COPD (chronic obstructive pulmonary disease) and suffocation may result in pulmonary edema.

Fluid Outside the Lungs

Pleural effusion is when fluid accumulates around the lung, in the pleural space. Blood (hemothorax), fatty lymphatic fluid (chylothorax) or pus (empyema) may also fill the pleural space although this occurs less frequently. Any fluid accumulation around the lungs should be taken seriously and requires immediate medical attention. The fluid accumulation around the lungs compress the lung and this prevents normal respiration, which results in inadequate gas exchange. The types and causes of pleural effusions are discussed in detail under fluid around the lungs.

Some Causes of Fluid Around the Lungs

  • Congestive cardiac failure is one of the most common causes of a pleural effusion. This fluid is more thicker (transudative) due to protein that is ‘forced’ out of the blood vessels and into the pleural space.
  • An exudative effusion is a watery fluid accumulation due to inflammation, caused by lung cancer like pleural mesothelioma, infections like TB or pneumonia, lung disease like asbestosis or drug reactions.
  • A hemothorax may be a result of a trauma or rupture of large blood vessels in the case of an aortic aneurysm although the latter causing a pleural effusion is uncommon.
  • An empyema is the accumulation of pus within the pleural space often due to a lung abscess.
  • A chylothorax is the accumulation of lymphatic fluid, which has a high concentration of fat, and may occur in certain cancers like lymphoma.
  • Some of the causes of fluid accumulation inside the lungs may also cause a pleural effusion, including kidney failure and liver disease.

Diagnosis of Fluid in the Lungs

Upon physical examination, your doctor will be able to identify abnormal sounds like bubbling or crackling (rales) with a stethoscope upon respiration. A wheezing sound (stridor) may be clearly audible as well when exhaling. Percussion is a tapping motion conducted against the chest wall and will assist your doctor with identifying areas of the lung that may be affected. Typically fluid accumulation causes a dull sound compared to the normal hollow sound of the air filled lung. Based on clinical findings and other signs and symptoms, your doctor may request further diagnostic investigations, which may include the following procedures.

  • A chest x-ray is one of the main diagnostic investigations conducted to identify the severity and area that is affected. For further imaging, a thoracic CT scan or chest ultrasound may be conducted.
  • Due to the incidence of cardiovascular disorders related to fluid in the lungs, your doctor may conduct an ECG (electrocardiography), ultrasound of the heart (echocardiography) and other cardiac investigations.
  • Fluid may be aspirated from the pleural space, which is known as thoracentesis, but this has to be carefully done to prevent a pneumothorax (accumulation of air in the pleural space). A pleural fluid analysis is then conducted to identify the type of exudate or any microorganisms.
  • A sputum culture may be necessary to identify the cause of infection.
  • A range of blood tests may be requested by your doctor to verify kidney and liver function, proper gas exchange and heart disorders.

Treatment of Fluid in the Lungs

Treatment is dependent on the cause of the fluid in the lungs. Some of the treatment options may include :

  • Antibiotics, antivirals or antifungals may be necessary in the case of an infection.
  • Diuretics assist with passing out additional fluid but should be used cautiously in the case of cardiac diseases.
  • Antihistamines may be necessary in allergic reactions and this may need to be continued on a chronic basis to prevent exacerbations.
  • Corticosteroids may be useful for controlling inflammation and mucus production, as in asthma, and this may be used long term to prevent acute attacks.
  • Chest drainage with a tube may be necessary for an empyema or a therapeutic thoracentesis may be required for a pleural effusion.
  • Anti-hypertensive drugs may be administered in cases of high blood pressure.
  • Oxygen is administered in severe cases of fluid in the lungs where proper gas exchange is impaired. While this does not immediately treat the cause of fluid in the lungs, except in a shortage of oxygen, it assists with adequate gas exchange.
  • Physiotherapy may be necessary to assist with mucus drainage.


  1. Pulmonary Edema. Merck
  2. Pleural Effusion. Pulmonology Channel
  3. Chylothorax. Medscape

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  • sanjay kulkarni

    fluid in left lung with cancer in both left & right have any permanenet or temporary diagnosis?

  • sanjay kulkarni

    Whether fluid in lungs with cancer have permanent diagnosis with 100% cure surity?

  • Dr. Chris

    Hi Sanjay

    Bit unsure what you mean by temporary or permanent diagnosis and 100% cure “surity”. If you are having difficulty with English. please refer to a forum in your native language or speak to your doctor because a lot can be lost in translation. Fluid accumulation in the lungs as a result of cancer does occur either in the lung or between the lung and chest wall. A lot depends on the type of and stage of cancer, treatment you are receiving and so on to determine if this would resolve.

  • aali

    my bro has been a drug addict for more than 10 years. he has been suffering from fever for almost 3 months now and always has an elevated body temperature. he was diagnosed with accumulation of fluid in his lungs but his mycoreal tested negative. still doctors are starting TB medication on him. please advice

  • otto10

    I have Fluid in Fissure in the lung.The Dr put me on fexofenadine hcl 180 mg.Can this be cured?

  • Dr. Chris

    Hi Aali

    His doctor must have made the decision based on some information that you may not be aware of. You or your brother should speak to the doctor and if you are unsatisfied, seek a second opinion from another doctor. The TB may not be in the lungs (pulmonary) and could have been detected elsewhere resulting in the prescription.

  • Dr. Chris

    Hi Otto10

    It is difficult to answer this without knowing what has been the cause of the fluid accumulation in lungs. Fluid in the lungs is only a sign of an underlying condition. In your case it seems to be related to hay fever or a post nasal drip so this is more a case of mucus in the lungs.

  • Brooookee

    i just found out that my dad has fluid in his lungs and his heart isnt working properly, will he die? im not sure on the details, because he lives over 15 hours away.

  • Dr. Chris

    Hi Brooookee

    There is no way for us to be able to provide any advice on your father’s lifespan. In terms of heart failure which can last for years, fluid collection in the lungs is a normal occurrence. More details are necessary though or we would be guessing.

  • Susan

    My Mom is 82years old, She has COPD for quite a few years. Three weeks ago she had an excabarated copd attack. She was hospitalised and treated with steroids, antibiotics and oxygen. She is home now. Her right ankle is very swollen (odema) on 60mg lasix, ankle very swollen and cold, also fluid in lungs. I know this is serious my Mom is very weak and is drifting in and out of sleep like trance for several minutes. Remembers nothing about the attack she had a few weeks ago. I am due to go on holidays saturday with my family and I don’t know whether to go or stay at home. Please advise me. Thanks

  • Dr. Chris

    Hi Susan

    From what you describe, it does seem quite serious, especially when considering your mom’s age. The strain on the heart due to COPD or some other cause which you may not be aware of may be resulting in heart failure which will begin to cause symptoms like swollen legs and so on. Confusion, loss of memory and drifting in and out of consciousness are also not good signs. However, she could make a full recovery with time and be back to normal. The only person who will be able to provide you with more direction is your mom’s doctor. He/she will be fully aware of your mom’s case and can advise you further.

  • kbowman06

    Dr. Chris,

    My grandfather has lung cancer, he is living off of one lung, the other is completely collapsed. He gets fluid in his lungs often, and in the past the Dr. drained the fliud. He is now considered to weak and volunerble for infection to do any more teatments like draining the fluid from his lungs (if it accumilates) or to inflate his other lung. So we are just waiting. It’s very hard for me to completely understand how this is going to happen. Is he going to drown when the fliud fills his lungs? isn’t this an inhumane way to let someone die? Please educate me.

  • Dr. Chris

    Hi Kbowman

    This is a rather sensitive situation and ideally you should sit down with your grandfather’s doctor and discuss the entire condition. Fluid accumulation in the lungs does not usually fill the entire lung so part of the lining is still able to exchange gases. The fluid accumulation may also be related to heart failure which can go on for years. Eventually the heart stops functioning sufficiently and the heart and lungs “shut down” (cardiorespiratory failure). Even in natural death, it is these centers that shut down so I am unsure whether you can refer to it as ‘inhumane’. If there is a risk of infection, you must remember that drugs can only help “kill” the microorganisms but it is the body’s innate ability to heal that has to take over and repair the damage and fight off any further infection. Your grandfather’s system may be unable to handle this.

    You have to understand that based on your grandfather’s age, prognosis and other factors, your doctor has to decide at what point ongoing therapy is viable or when a person should be allowed to continue without treatment. Will treatment allow your grandfather a good quality of life or will he suffer for another few weeks or months? Can his body heal sufficiently that he can live a long life? These are all the aspects that are brought into question and you have to draw a line between your emotions and the suffering that your grandfather may be experiencing. This is of course depending on whether your information is correct and this is why I would advise that you speak to his doctor to get a clearer perspective.

    It is is a difficult situation and I am sorry for your predicament. I hope this information helps to some extent.

  • dizzydia

    hi my mother is 62 and has just been diagonosed with permanent af , but is awaiting advice from the doctor who has written away to a cardiologiston wot to do ?, in the meantime she was breathless and she had an x ray and the results is that she had fluid on the lungs the edema one , she has been given water tablets from the doctor, but she also high blood pressure and is on 2 tablets a day, aswell as an underactive throid gland and is on medication for that , and was wondering on any advice you can give me , shes not on any medication for the af as yet , thanks

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  • Dr. Chris

    Hi Dizzydia

    I am unsure as to what advice you are looking for. You have not asked a question. Your mother’s condition is being managed by her doctor in consultation with a cardiologist. You should direct your questions at him on specific issues that you have in mind. When a patient has a multitude of co-existing conditions, the doctor may not opt to treat each condition separately. Atrial fibrillation means that the way the heart is pumping is affected. This can increase the chances of blood clot formation and result in a stroke etc. It depends on how serious the condition is and what other medication your mother is currently using. If it is not too severe or medication for AF is contraindicated with your mother’s current drug regimen, the doctor may delay prescribing medication.

  • D.Robinson

    My Brother has back problems 4 & 5 Vertabrae is shot. I took him to the ER a week ago Saturday. He is a Diabetic his sugar was 521 they put him on insulin and did other tests CT scan and bloodwork. He is anemic Hemo was 8.8. They saw something in the CT scan and think there is a possibility he has kidney cancer and there is a pollop on his lungs. they wanted to do biopsies and he refused. His back started acting up about 3 months ago and he has been down in bed this lenght of time not getting much movement. He started developing a cough about 3 weeks ago and shortness of breath even to get up and go to the bathroom or eat. Showereing just plain wears him out. Could he have fluid on his lungs from not being mobile for so long. He has lost about 40 lbs in this 3 months and his muscle is deteriating. Please need a few answers. Thank You

  • Dr. Chris

    Hi D.Robinson

    His symptoms are severe an worrying, and his condition is obviously deteriorating. The fluid in the lungs would be due to some other cause and inactivity MAY exacerbate it but this is not the sole cause. The biopsy needs to be done and your brother has to realize that failing to do so, as well as refusing treatment, may shorten his lifespan significantly. It would be irresponsible to even attempt to diagnose him at this point by the information you have offered but his symptoms indicate a very serious causes – possibly cancer, an autoimmune disease or even systemic infection. He needs medical assistance immediately.

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  • Walter

    My friend of 35 years has cancer of the lungs. His doctors tell him its stable. He has had it for three years, now he has fluid in thetorax ans is short of breath. He had 2 L drained. What causes this . He is on a new drug the latest to stop the progression can the drug cause this or is this it for my friend.

  • Dr. Chris

    Hi Walter

    It is difficult to say whether this is the last stages. Your friend needs to discuss this with his doctor. Lung cancer is usually very aggressive and depending on the type of malignancy, stage at which it was diagnosed and treatment he underwent at the time, it could be recurring or progressing. Alternatively the fluid accumulation may not be related to the cancer. Two liters is quite significant but there is no need to assume the worst right now. Only his doctor will be able to give you an assessment based on his/her knowledge of your friend’s case.

  • iwannarace

    can multiple surgeries (3 major in one month) cause this “mucus” buildup. (68 year old female).

  • Dr. Chris

    Hi Iwannarace

    Yes, it is possible, especially if it associated with a nosocomial infection (hospital acquired). You can read about this more under What is pneumonia? and Types of Pneumonia. Depending on your medical history, reaction to the anesthesia, and inactivity, there may be various other causes that may be applicable.

  • joy joyce

    pls i really nid ur hlp on dis,d doctor says my mum has stage 3 cancer of the breast,hers started 4rm d nipple,dey say its pagets disease,n shes undergone 3 bouts of chemotherapy n went ahead 2 receive d radiotherapy,all seemed 2 b goin on well xcept for d loss of weight,hair loss,general weakness which she was handling well until few mnths back wen suddenly fainted,choking lyk shes lost all air,we rushd her 2 d hospital,we did an immediate chest scan,it waz diagnosd dat d cancer had metasised,she has pleural effusion,shortness of breath n cant even walk on her own,pls doctor shes all iv got n i dnt want 2 lose her,wot do we do 2 get her back on her feet,shes only 45yyrs of age,they have bin drainin d fluid but it comes ryt bak again,pls help,our finance has gone dry.thanks,God bless

  • Dr. Chris

    Hi Joy Joyce

    Unfortunately there is little that I can advise here. You need to take your mom back to her doctor, preferably an oncologist (cancer specialist). If it really is metastases, then there may be very few options given the number of rounds of chemotherapy she has already undergone. But let the oncologist advise you further.

  • joy joyce

    pls i need to know,is there sumtin we can stil do 2 help her,probably sumtin we v nt tried or are we fighting a lost cause

  • Dr. Chris

    Joy Joyce,

    We cannot comment on your mother’s condition further as it is quite a severe case as result of cancer spread (metastases). Her doctors are obviously taking the necessary actions within their abilities to try to ease her suffering. We can also not say whether your mother’s situation is a “lost cause” or not. Her doctors are in a better position to discuss the prognosis.

  • tracy

    does a protracted cough imply fluid in the lung? we have ruled out TB with TB serology test and a load of antibiotics have been used but still the cough persists. do we need a ct scan? pls ur advice is needed.

  • Dr. Chris

    Hi Tracy

    Not necessarily. Could be a host of other causes. Best assessed on the history. May not be infectious or bacterial specifically so antibiotics will not help. You should see a pulmonologist. It may be the start of COPD.

    Here are two articles that may help you find more information :
    Persistent Cough
    Dry Cough

  • Ruben

    I went to the ER because I was having a hard time sleeping. I was unable to lay down I had to sit on the edge of my bed.An xray wa taking and it was determined that I was retaing fluid. The Doctor gave Laxix it did help a little. Meanwhile I called the hospital to get my ER notes to take to my own Doctor. To my surprise when I got the xray it said that I have pnuemonina. I immediatly started taking Avalox.I am now on my 10th of medication but I still get shortness of breath when doing cardio and my ankles are still swelling…Can my problem be handled with medication or will I need to be hospitilized ?

  • Dr. Chris

    Hi Ruben

    Antibiotics will treat bacterial pneumonia but the symptoms will not go away immediately. Pneumonia is an infection of the lung and inflames the tissue lining which takes a time to settle even if the infection resolves. Hopefully you saw a doctor who prescribed this medication and that it was verified that this was a case of bacterial pneumonia. You should speak to your doctor about your concerns so that the treatment can be changed or additional medication prescribed if necessary.

  • Marlene

    My mom has breast cancer 8 years ago and now metastisize in her shoulder. She has edema on her left hand. Now she has fluid in her lung due to chemo side effect. Two weeks ago, the pulmonoligist inserted a catheter in to drain fluid in her lung.
    My question is, is there something we can do or something to take to help her in her breathing? She has plenty of plegm too. She has shortness of breath most of the time and cannot get a good night sleep. Is there a proper way to sleep posture? Thank!

  • Alittlewheezy

    Dr Chris;

    For the past few weeks I’ve been fighting off a very nasty cold. It left me with a chest infection which was treated with Amoxycillin 500mg three times a day. I finished the course a few days ago but I am still persisting with the symptoms of my chest infection, including a heaviness on my chest, a feeling like I am drowning when I try to breathe and a persistant cough. I am a 28 yr old non smoker (never smoked once). Am I looking at Bronchitis? I plan to attend the doctors on monday, should I ask for a follow up checkup on this?

  • Dr. Chris

    Hi Marlene

    It’s important to discuss all these aspects with the pulmonologist and/or oncologist. Please be very careful about home remedies and so on for a patient on chemo. The internet is full of information that can actually be harmful. She may find some relief by being propped up on an extra pillow. Her doctor will be able to advise you further.

  • Dr. Chris

    Hi Alittlewheezy

    It seems quite likely that this is a case of bronchitis. Even if the infection resolves, the symptoms may persist for week afterwards. However it is better to let your doctor assess you just in case it may be due to some other condition. Yes, you should mention this to your doctor.

  • Alittlewheezy

    Dr Chris;

    Thanks for the helpful feedback. I attended my GP and was given Doxycycline 100mg, one a day (two on the first). He also booked me in for a chest x-ray as he suspects I have pneumonia. I am now coughing up clear bitter fluid, sometimes tinged with brown. I am unfamiliar with the treatments for pneumonia, is there anything I can do to keep myself comfortable whilst waiting for results? Thank you.

  • Dr. Chris

    Hi Alittlewheezy

    Bed rest, good nutrition (including plenty of fluids) and avoiding stress are the best conservative measures that you can adopt. It will take some time for the antibiotics to have its full effect plus it also depends on the extent of damage to the lung tissue. But “taking it easy” so to say at this point is crucial for a speedy recovery. Your doctor will advise you further.

  • elizabell

    My mum had a cough, and I did too, but mine went with antibiotics and a few weeks ago my mums returned, she went to the doctor who sent her for an xray, she was then rushed to a private room, where they said they cant rule anything out, even cancer! She had some fluid drained, and they are going to tell the results in a week, but what else could it be? Are all condition serious? If it is cancer will she have a chance to fight it?

  • Dr. Chris

    HI Elizabell

    This could have been a respiratory tract infection that progressed into pneumonia. You can find more information in this article on What is Pneumonia. This is just one possibility and you should wait for the doctors to get back to your with the results. There is no need to assume cancer just yet, unless your mum had other symptoms like a bloody cough and has been a smoker. There may be other conditions like heart disease that can also cause fluid in the lungs. Speak to the doctor handling the case.

  • corean wheeler


  • Alittlewheezy

    Its been a couple of weeks now, and I’m still a little breathless – had one of my blood results come back with an elevated ESR. I’m told that this is normal if the test was taken whilst I was suffering with the infection/illness I had to my lungs and they want me to repeat the test in a couple of weeks.Is this something I should be worried over or is it as they say, par for the course with inflammation around my lungs from infection? I finished the antibiotics, just making the rest of the climb back to normalcy now and feeling better for the twofold advice of ‘rest’!

  • Dr. Chris

    Hi Alittlewheezy

    If it was pneumonia, recovery will take come time even after completing teh antibiotics and once the infection resolves. It also depends on whether complications like pleurisy arose and the extent of permanent damage, if any, to the lung tissue. Your doctor would consider a further chest x-ray at a laters stage if these symptos persist. So your current symptoms are not uncommon but keep checking with your doctor, especially if you find these symptoms are getting worse.

  • Dr. Chris

    Hi Corean Wheeler

    It is difficult comment further than what your doctor has told you. While initially it seemed like a progression of the respiratory tract infection, your doctor is obviously familiar with your case and medical history to have brought congestive heart failure in questions. You are obviously at risk for developing this condition coupled with findings on the x-ray for your doctor to have been concerned. The inability of your heart to pump efficiently allows fluid from the blood to “leak” into the lungs. It could be chronic meaning that it was slowly developing over time although you were asymptomatic or suddenly set in (acute). Only your doctor can advise you further since she is aware of your case so speak to her about your concerns.