Pulmonary Edema

Written by Lydia Krause
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP

What Is Pulmonary Edema?

Pulmonary edema is a condition in which the lungs fill with fluid. When this occurs, the body struggles to get enough oxygen.

The most common cause of pulmonary edema is congestive heart failure. Heart failure is characterized by the heart no longer being able to pump blood properly throughout the body.

In pulmonary edema, the heart works harder to push blood through the body. This puts added pressure on the small blood vessels of the lungs. In order to relieve this growing pressure, the vessels release fluid into the lungs.

Ordinarily, the lungs are responsible for taking oxygen from the air that you breathe and putting that oxygen into the bloodstream. However, if the lungs are filled with fluid, they cannot properly perform that task. In cases of pulmonary edema, the lungs cannot put oxygen into the bloodstream, and the rest of the body is deprived of oxygen.

When doctors treat pulmonary edema, they work to remove the fluid from the patient’s lungs. If fluids are not removed and continue to accumulate, a patient may literally drown. Treating the cause of pulmonary edema is the best method for a full recovery.

Risk Factors of Pulmonary Edema

Patients with heart problems or heart failure are the most at risk for pulmonary edema. Other factors which may also put a person at risk include:

  • prior history of pulmonary edema
  • history of lung disease, such as tuberculosis, chronic obstructive pulmonary disorder (COPD)
  • vascular (blood) disorders

Causes of Pulmonary Edema

Congestive heart failure is the most frequent cause of pulmonary edema. However, there are a number of less common medical conditions that can cause pulmonary edema, such as:

  • heart attack, or other heart diseases
  • leaking, narrowed, or otherwise damaged heart valves
  • sudden high blood pressure
  • pneumonia
  • kidney failure
  • lung damage (caused by severe infection)
  • severe sepsis of the blood (blood poisoning caused by infection)
  • pancreatitis (inflammation of the pancreas)

However, pulmonary edema is not always caused by an internal medical condition. The condition can also be caused by outside factors that put extra pressure on the lungs and heart. These factors include:

  • high altitude exposure
  • illicit drug use and/or drug overdose
  • lung damage (caused by inhalation of toxins)
  • severe trauma
  • major injury
  • near-drowning

Symptoms of Pulmonary Edema

Blood is filled with oxygen from your breath in your lungs. Oxygen is then carried throughout the body to every organ and tissue. In cases of pulmonary edema, the lungs fill with fluid. As the amount of fluid in the lungs increases, the body struggles to gain oxygen. The symptoms will grow progressively worse until the fluid is removed.

Symptoms of pulmonary edema include:

  • breathlessness (feeling like you can’t catch your breath)
  • difficulty breathing (may be worse when you are lying flat on your back)
  • coughing
  • wheezing
  • coughing up blood
  • excessive sweating
  • decreased alertness
  • leg swelling
  • abnormal heart rate

Severe symptoms of pulmonary edema include:

  • shock
  • respiratory failure
  • organ death from lack of oxygen

Diagnosis of Pulmonary Edema

Doctors will look for fluid in your lungs or symptoms caused by its presence. When you visit your doctor, he or she will perform a basic physical examination. Your doctor will listen to your lungs with a stethoscope, discuss your symptoms, and ask about your medical history. If he or she believes you have fluid in your lungs, your doctor will order additional tests.

Examples of tests used in diagnosing pulmonary edema include:

  • echocardiogram (an ultrasound) to check for abnormal heart activity
  • chest X-ray (CXR) to see fluid
  • blood tests to check oxygen levels
  • electrocardiogram (ECG) to look for heart rhythm problems or signs of a heart attack

Treatment of Pulmonary Edema

Pulmonary edema is a serious condition. Quick treatment is necessary. In severe cases, patients may be need to be treated in intensive or critical care.

Treatments for pulmonary edema include:

  • aspiration (fluid is sucked from the lungs using a tube inserted down the throat)
  • diuretics (medication used to remove fluid from the body)
  • heart medications to control your pulse and relieve pressure
  • surgery (opening the chest and removing the fluid)

Some cases of pulmonary edema may need treatment with mechanical ventilation. This could be as simple as giving you an oxygen mask to place over your mouth and nose. However, your doctor may need to use an endotracheal tube (breathing tube) inserted down your throat to deliver oxygen directly to your lungs.

Prevention of Pulmonary Edema

There is no way to fully prevent pulmonary edema. Those with high risk conditions should seek immediate attention if they develop symptoms of the disorder. The best way to prevent any disorder is by taking good care of your health by:

  • getting a pneumonia vaccine
  • getting the flu vaccine (especially if you have heart problems or if you are elderly)
  • remaining on diuretics after an episode of pulmonary edema in order to prevent a reoccurrence

You can avoid heart failure (the most prominent cause of pulmonary edema) by:

  • visit the doctor regularly
  • refraining from smoking or recreational drug use
  • beginning a regular exercise routine
  • eating healthy foods
  • maintaining a normal weight

Outlook for Pulmonary Edema

The outlook for pulmonary edema depends upon the severity of the particular case. In minor cases that receive quick treatment, patients often have a full recovery. However, even with treatment, some severe cases may be fatal.

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