Pulmonary edema is a serious condition that occurs when the lungs fill with fluid. This prevents the body from gaining the oxygen it needs. It is typically caused by another condition, such as heart failure or altitude sickness.

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 may experience shortness of breath or wheezing.

Pulmonary edema can range in severity. Some people may need critical care. Often, treatment involves treating pulmonary edema along with the related underlying condition.

Timely treatment can improve possible outcomes.

Several possible health conditions and external factors can cause pulmonary edema.

Congestive heart failure

Congestive heart failure (CHF) is a common cause of pulmonary edema.

Heart failure happens when the heart can no longer pump blood properly throughout the body. This creates a backup of pressure in the small blood vessels in the lungs, which causes the vessels to leak fluid.

Typically, 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
  • cardiomyopathy
  • cardiac arrhythmias
  • sudden high blood pressure
  • pneumonia
  • kidney failure
  • lung damage caused by severe infection
  • severe sepsis of the blood, or blood poisoning caused by infection

External factors

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

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

In cases of pulmonary edema, your body cannot gain oxygen effectively. This is due to the increasing fluid in the lungs preventing oxygen from moving into the bloodstream. Symptoms may continue to worsen until you get treatment.

Symptoms depend on the type of pulmonary edema.

Long-term pulmonary edema

The symptoms of long-term pulmonary edema include:

  • shortness of breath when 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
  • edema, or swelling in the lower part of the body
  • fatigue

High-altitude pulmonary edema

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

You may need emergency assistance if these symptoms start to get worse. Call 911 or your local emergency services or have someone drive to you the hospital. If you may have pulmonary edema, you should not drive yourself to the hospital.

Pulmonary edema can be an emergency.

Call 911 or your 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 breathe
  • anxiety related to trouble breathing
  • cough that produces a pink, frothy mix of saliva and mucus
  • chest pain
  • rapid, irregular heart rate
  • 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 cause you to drown.

If a doctor suspects you may have pulmonary edema, they may look for fluid in your lungs or symptoms caused by it. They may 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

A doctor may also look for some signs on your body. These may include:

  • fluid buildup around your neck
  • swelling in your legs and abdomen
  • pale or blue tones in your skin
  • cold, clammy skin

The doctor may discuss your symptoms and ask about your medical history. They may order additional tests if they believe you have fluid in your lungs.

Examples of tests used in diagnosing pulmonary edema include:

Pulmonary edema is a serious condition that requires quick treatment. Treatment for pulmonary edema may include:

Oxygen

Oxygen may be the first line of treatment for this condition, depending on the severity. A healthcare team may prop you up and deliver 100 percent oxygen through an oxygen mask, nasal cannula, or positive pressure mask.

Diuretics

In less severe cases, it may be treated with diuretics, or water pills. You may not have to stay in the hospital. This may be the case if you have congestive heart failure.

Treatment of the underlying condition

A 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, the doctor may also prescribe:

  • Preload reducers: These help decrease pressure 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.
  • Morphine: This narcotic is used to relieve anxiety and shortness of breath. But fewer doctors today use morphine due to its risks.

Intensive or critical care

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

In other cases of pulmonary edema, you may need treatment to help you breathe. A machine will deliver oxygen under pressure to help get more air into your lungs. Sometimes this can be done with a mask or cannula, also called continuous positive airway pressure (CPAP).

Your doctor may need to insert an endotracheal tube, or breathing tube, down your throat and use mechanical ventilation.

Pulmonary edema is sometimes confused with pleural effusion, another condition involving fluid buildup in the lungs. However, pleural effusion causes a buildup of fluids in the pleural tissues. These cover the outside of each of your lungs as well as the inside of the chest wall.

Causes of pleural effusion may include:

  • CHF
  • inadequate nutrition
  • pneumonia or tuberculosis
  • liver cirrhosis
  • pancreatitis
  • lupus
  • rheumatoid arthritis
  • cancer

With pleural effusion, you may experience:

  • breathing difficulties
  • a dry cough
  • shortness of breath
  • chest pain and discomfort

A chest X-ray can help diagnose pleural effusion. A doctor may take a biopsy from pleural tissues if they suspect cancer. Depending on the cause, pleural effusion may be treated with a combination of fluid removal techniques and surgery.

Pneumonia is another serious condition of the lungs. Unlike edema, pneumonia is caused by viral, fungal, or bacterial infection. As your lungs become infected, fluid builds up in the air sacs (alveoli).

While pulmonary edema and pneumonia cause buildup in the lungs, the former is primarily caused by CHF. Pneumonia, on the other hand, is caused by an infection. A weakened immune system can increase your chances of getting pneumonia from a common cold or flu.

Symptoms of pneumonia may include:

  • high fever with chills
  • cough with mucus that continues to worsen
  • chest pain and discomfort
  • shortness of breath
  • nausea or vomiting
  • diarrhea

According to the American Lung Association, pneumonia is one of the most common causes of hospitalization in children and adults.

If left untreated, this condition can lead to:

Pulmonary edema isn’t a cause of pneumonia. However, the buildup of fluids from pneumonia can lead to pleural effusion. Pneumonia requires immediate treatment to prevent complications. It may require antibiotics and oxygen therapy.

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:

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

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 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 with the following steps:

  • Visit a doctor regularly.
  • Avoid smoking or quit smoking if you smoke.
  • Avoid illegal drugs.
  • Get regular exercise.
  • Eat nutritious foods.
  • Maintain your weight.

The outlook for pulmonary edema depends on the severity. 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 a doctor regularly and get immediate help if you experience any pulmonary edema symptoms.

If you need help finding a primary care doctor, you can browse doctors in your area through the Healthline FindCare tool.

Pulmonary edema is a health condition when the lungs fill with fluid. This fluid can prevent the body from effectively receiving oxygen.

You may experience shortness of breath after exertion and during rest. The severity can range from moderate to severe. Pulmonary edema requires prompt medical treatment.

Pulmonary edema occurs due to another condition, most commonly congestive heart failure. Treatment may involve treating pulmonary edema and its underlying cause.

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