Pulmonary edema involves fluid accumulation and swelling in the lungs.
Alternative Names
Lung/pulmonary congestion; Congestive heart failure; Lung water
Causes, incidence, and risk factors
Pulmonary edema is usually caused by heart failure that results in increased pressure in the pulmonary (lung) veins. However, problems within the lungs themselves can also result in fluid accumulation. Pulmonary edema can be a complication of a myocardial infarction ( heart attack ), leaking or narrowed heart valves (mitral or aortic valves), or any disease of the heart that either results in weakening and/or stiffening of the heart muscle ( cardiomyopathy ). The failing heart transmits its increased pressure to the lung veins. As pressure in the lung veins rises, fluid is pushed into the air spaces (alveoli). This fluid then becomes a barrier to normal oxygen exchange, resulting in shortness of breath. Pulmonary edema can also be caused by direct lung injury from toxins including heat and poisonous gas, severe infection, or an excess of body fluid as seen in kidney failure.
Signs and tests
Signs :
Rapid breathing and increased heart rate Listening to the chest with a stethoscope ( auscultation ) may reveal the following:
Crackles (rales) in the lungs Abnormal heart sounds (murmurs, extra heart sounds) pale or blue skin color Tests :
Blood oxygen levels (low) A chest X-ray may reveal the following:
Fluid in or around the lung space Enlarged heart An ultrasound of the heart (echocardiogram) may reveal the following:
Weak heart muscle Leaking or narrow heart valves Fluid surrounding the heart
Treatment
Oxygen is given via nasal prongs or face mask. Intubation (breathing tube placed into the windpipe) and use of a breathing machine (ventilator) may be needed. Underly causes must be rapidly identified and treated. For example, if a heart attack has caused the condition, the heart must be treated and stabilized. Medications to accelerate water excretion from the body via the urine (diuretics) are given. One common diuretic is lasix (furosemide). Other medications to strengthen the heart muscle or to relieve the pressure on the heart may also be given as needed.
Expectations (prognosis)
Although pulmonary edema can be a life-threatening condition, it is often readily treatable. Prognosis, however, depends upon the underlying disease.
Complications
Long-term dependence on a breathing machine (ventilator)
Calling your health care provider
Go to the emergency room or call the local emergency number (such as 911) if conditions suggesting pulmonary edema occur, particularly if breathing is difficult.
Prevention
In patients with known diseases that can lead to pulmonary edema, strict compliance with taking medications in a timely manner and following an appropriate diet (usually, low in salt) can significantly decrease one's risk.