Medically reviewed by University of Illinois — Written by Stephanie Brunner on December 18, 2017 Pulmonary edema occurs when fluid accumulates in the air sacs of the lungs – the alveoli – making it difficult to breathe. This interferes with gas exchange and can cause respiratory failure. Pulmonary edema can be acute (sudden onset) or chronic (occurring more slowly over time). If it is acute, it is classed as a medical emergency needing immediate attention. The most common cause of pulmonary edema is congestive heart failure, where the heart cannot keep up with the demands of the body. Treatment of pulmonary edema usually focuses on improving respiratory function and dealing with the source of the problem. It generally includes providing additional oxygen and medications to treat the underlying conditions.
To raise the patient’s blood oxygen levels, oxygen is given either through a face mask or prongs – tiny plastic tubes in the nose. A breathing tube may be placed into the trachea if a ventilator, or breathing machine, is necessary. If tests show that the pulmonary edema is because of a problem in the circulatory system, the patient will be treated with intravenous medications to help remove fluid volume and control blood pressure. During normal breathing, the small air sacs in the lungs – alveoli – fill up with air. Oxygen is taken in, and carbon dioxide is expelled. Pulmonary edema occurs when the alveoli are flooded. When the alveoli are flooded, two problems occur:
Common causes include: Besides direct injury to the lungs, as in ARDS, other causes include:
Cardiogenic pulmonary edemaPulmonary edema that is due to a direct problem with the heart is called cardiogenic. Congestive heart failure is a common cause of cardiogenic pulmonary edema; in this condition, the left ventricle cannot pump out enough blood to meet the needs of the body. This causes a buildup of pressure in other parts of the circulatory system, forcing fluid into the air sacs of the lungs and other parts of the body. Other heart-related problems that can lead to pulmonary edema include:
Causes of pulmonary edema that are not due to poor heart function are called noncardiogenic; they are typically caused by ARDS (acute respiratory distress syndrome). This is a severe inflammation of the lungs that leads to pulmonary edema and significant breathing difficulties. Acute pulmonary edema causes significant breathing difficulties and can appear without warning. This is an emergency and requires immediate medical attention. Without proper treatment and support, it can be fatal. Along with breathing difficulties, other signs and symptoms of acute pulmonary edema can include:
If the pulmonary edema is chronic, symptoms are normally less severe until the body’s system can no longer compensate. Typical symptoms include:
Pulmonary edema happens when fluid collects inside the lungs, in the alveoli, making it hard to breathe. Plural effusion also involves fluid in the lung area, and it is sometimes called “water on the lungs.” However, in pleural effusion, water fluid collects in the layers of the pleura that are ouside the lungs. It can result from heart failure, cirrhosis, or a pulmonary embolism. It can also occur after heart surgery. Pulmonary edema can overlap with pneumonia, but it is a different condition. Pneumonia is an infection that often occurs as a complication of a respiratory infection, such as the flu. It can be difficult to distinguish between the two. If the individual or a family member can provide a detailed medical history, this will make it easier for a physician to make the correct diagnosis and provide the right treatment. Share on PinterestSometimes, a chest X-ray can assist in the diagnosis of pulmonary edema. The patient will undergo a physical exam first. The doctor will use a stethoscope to listen to the lungs for crackles and rapid breathing, and the heart for abnormal rhythms. Blood tests will be carried out to determine blood oxygen levels; the doctor will often order other blood tests, including:
An ultrasound of the heart, an echocardiogram, and an electrocardiogram (EKG) can help determine the condition of the heart. A chest X-ray may be used to see whether there is any fluid in or around the lungs and to check the size of the heart. A CT scan of the chest may also be ordered. Patients with an increased risk of developing pulmonary edema must follow their doctor’s advice to keep their condition under control. If congestive heart failure is the problem, following a healthy, well-balanced diet, and maintaining a healthy body weight can help reduce the risk of future episodes of pulmonary edema. Regular exercise also improves heart health as does:
Altitude-induced pulmonary edema can be minimized by making a gradual ascent, taking medications before traveling, and avoiding excess exertion while progressing to higher altitudes. Read this article in Spanish. Last medically reviewed on December 18, 2017
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