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.
But timely treatment for pulmonary edema and its underlying cause can improve possible outcomes.
There are several possible causes of pulmonary edema.
Congestive heart failure
The most common cause of pulmonary edema is congestive heart failure (CHF). 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 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
- kidney failure
- lung damage caused by severe infection
- severe sepsis of the blood, or blood poisoning caused by infection
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
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 bloodstream. Symptoms may continue to worsen until you get treatment.
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
- 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
High-altitude pulmonary edema
Pulmonary edema due to altitude sickness, or not getting enough oxygen in the air, will have symptoms that include:
- irregular, rapid heartbeat
- shortness of breath after exertion and during rest
- difficulty walking uphill and on flat surfaces
Get emergency assistance if these symptoms start to get worse. Do not drive yourself to the hospital.
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. They will also discuss your symptoms, and ask about your medical history. If they believe you have fluid in your lungs, they’ll order additional tests.
Examples of tests used in diagnosing pulmonary edema include:
Pulmonary edema is a serious condition that requires quick treatment. Oxygen is always the first line of treatment for this condition. Your healthcare team may 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. These help 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.
- Morphine. This narcotic is used to relieve anxiety and shortness of breath. But fewer doctors today use morphine due to the risks.
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.
Sometimes pulmonary edema is confused with pleural effusion, another condition that involves fluid buildup in the lungs. However, pleural effusion specifically 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.
Pleural effusion can be caused by CHF, poor nutrition, and pneumonia. It’s also sometimes cancerous (malignant).
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. Your doctor may take a biopsy from pleural tissues if cancer is suspected. 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 either a viral, fungal, or bacterial infection. As your lungs become infected, fluid builds up in the air sacs (alveoli).
While both pulmonary edema and pneumonia cause a form of 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 and/or vomiting
Pneumonia is one of the most common causes of hospitalization in children and adults, according to the American Lung Association. When 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, which may require antibiotics and oxygen therapy.
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 breathe
- anxiety related to trouble breathing
- cough that produces a pink, frothy mix of saliva and mucus
- chest pain
- rapid, irregular heartbeat
- 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.
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 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 with the following steps:
- Visit your doctor regularly.
- Don’t smoke or use recreational drugs.
- Get regular exercise.
- Eat healthy foods.
- Maintain a normal weight.
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.