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What Is Pulmonary Edema?

What is pulmonary edema?

Key points

  1. Pulmonary edema is a condition in which the lungs fill up with fluid so the body struggles to get enough oxygen.
  2. People with heart problems or heart failure have the highest risk for pulmonary edema.
  3. Treatment involves medications, procedures to take fluid out of the lungs, and sometimes surgery.

Pulmonary edema is a condition in which the lungs fill with fluid. It’s also known as lung congestion, lung water, and pulmonary congestion. When pulmonary edema occurs, the body struggles to get enough oxygen and you start to have shortness of breath.

Your outlook improves with timely treatment for pulmonary edema and its underlying cause.

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Symptoms

Symptoms of pulmonary edema

In cases of pulmonary edema, your body will struggle to gain oxygen. This is due to the amount of increasing fluid in the lungs preventing oxygen moving into the blood stream. Symptoms will grow worse until your doctor removes the fluid.

Symptoms depend on the type of pulmonary edema.

Long-term pulmonary edema

The symptoms for long-term pulmonary edema include:

  • shortness of breath when being physically active
  • difficulty breathing when lying down
  • wheezing
  • waking up at night with a breathless feeling that goes away when you sit up
  • rapid weight gain, especially in the legs
  • swelling in the lower part of the body
  • fatigue

High altitude pulmonary edema

Pulmonary edema due to high altitude sickness, or not getting enough oxygen in the air, will have symptoms that include:

  • headaches
  • irregular, rapid heartbeats
  • shortness of breath after exertion and during rest
  • coughing
  • fever
  • difficulty walking uphill and on flat surfaces

Get emergency assistance if these symptoms start to get worse. Do not drive yourself to the hospital.

Call a doctor

When is it an emergency?

Call 911 or local emergency services immediately for medical help if you experience any of these symptoms:

  • extreme breathing difficulties, or shortness of breath, like suffocating or drowning
  • inability to breath
  • anxiety related to trouble breathing
  • cough that produces a pink, frothy mix of saliva and mucus
  • chest pain
  • rapid, irregular heartbeats
  • blue or gray skin tone
  • sweating along with breathing difficulties

These may be symptoms of acute pulmonary edema. Acute pulmonary edema develops suddenly. If left untreated, the fluid in your lungs can make you drown.

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Causes

Causes of pulmonary edema

Congestive heart failure

The most common cause of pulmonary edema is congestive heart failure (CHF). Heart failure is when the heart can no longer pump blood properly throughout the body. This creates a back-up of pressure in the small blood vessels of the lungs, which causes the vessels to leak fluid.

In a healthy body, the lungs will take oxygen from the air you breathe and put it into the bloodstream. But when fluid fills your lungs, they cannot put oxygen into the bloodstream. This deprives the rest of the body of oxygen.

Other medical conditions

Other less common medical conditions that can cause pulmonary edema include:

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

External factors

Some external factors can also put extra pressure on the heart and lungs and cause pulmonary edema. These outside factors are:

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

Risk factors

Risk factors of pulmonary edema

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

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Diagnosis

Diagnosis of pulmonary edema

You doctor will look for fluid in your lungs, or symptoms caused by its presence. They will perform a basic physical examination and listen to your lungs with a stethoscope, looking for:

  • an increased heart rate
  • rapid breathing
  • a crackling sound from your lungs
  • any abnormal heart sounds

Your doctor may also look at your neck for fluid buildup, legs and abdomen for swelling, and if you have pale or blue-colored skin. Your doctor will also discuss your symptoms, and ask about your medical history. If they believe you have fluid in your lungs, they will order additional tests.

Examples of tests used in diagnosing pulmonary edema include:

  • complete blood count
  • echocardiogram, or an ultrasound, to check for abnormal heart activity
  • chest X-ray (CXR) to see fluid
  • blood tests to check oxygen levels
  • echocardiogram, to see if there are problems with the heart muscle
  • electrocardiogram (ECG) to look for heart rhythm problems or signs of a heart attack
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Treatment

Treatment of pulmonary edema

Pulmonary edema is a serious condition that requires quick treatment. Oxygen is always the first line treatment for this condition. Your healthcare team will prop you up and deliver 100 percent oxygen through an oxygen mask, nasal cannula, or positive pressure mask.

Your doctor will also diagnose the cause of pulmonary edema and prescribe the appropriate treatment for the underlying cause.

Depending on your condition and the cause of your pulmonary edema, your doctor may also give:

  • Preload reducers: This helps decrease pressures from the fluid going into your heart and lungs. Diuretics also help reduce this pressure by making you urinate, which eliminates fluid.
  • Afterload reducers: These medications dilate your blood vessels and take pressure off your heart.
  • Heart medications: These will control your pulse, reduce high blood pressure, and relieve pressure in arteries and veins.
  • Suction catheter: A small suction catheter may be used to help remove fluid from the lungs.
  • Morphine: This narcotic is used to relieve anxiety and shortness of breath. But fewer and fewer doctors use morphine due to the risks.

In severe cases, people with pulmonary edema may need intensive or critical care.

Some cases of pulmonary edema may need treatment to assist breathing. A machine will deliver oxygen under pressure to help get more air into the lungs. Sometimes this can be done with a mask or cannula, also called Continuous Positive Airway Pressure (CPAP).  Or your doctor may need to insert an endotracheal tube, or breathing tube, down your throat and use mechanical ventilation.

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Prevention

Prevention of pulmonary edema

There is no way to fully prevent pulmonary edema. Those at high risk should seek immediate attention if they develop symptoms of the disorder.

The best way to try and prevent pulmonary edema is by taking good care of your health:

  • Get a pneumonia vaccine.
  • Get the flu vaccine, especially if you have heart problems or if you are an older adult.
  • Remain on diuretics after an episode of pulmonary edema to prevent a reoccurrence.

You can also decrease your risk for heart failure, the most common cause of pulmonary edema:

  • Visit your doctor regularly.
  • Don’t smoke or use recreational drugs.
  • Get regular exercise.
  • Eat healthy foods.
  • Maintain a normal weight.

Outlook

Outlook for pulmonary edema

The outlook for pulmonary edema depends on the severity of your case. If you have a moderate case and receive quick treatment, you will often have a full recovery. Severe cases can be fatal if you delay treatment.

Be sure to see your doctor regularly, and get immediate help if you experience any of the symptoms of pulmonary edema.

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