Pulmonary edema

Pulmonary edema is an abnormal build up of fluid in the lungs, which leads to swelling.

Pulmonary edema is usually caused by heart failure. As the heart fails, pressure in the vein going through the lungs starts to rise. As the pressure increases, fluid is pushed into the air spaces (alveoli). This fluid interrupts normal oxygen movement through the lungs, resulting in shortness of breath.

Pulmonary edema may be caused by damage directly to the lung, such as that caused by poisonous gas or severe infection. Lung damage and a build up of body fluid is also seen in kidney failure.

Pulmonary edema may also be a complication of a heart attack, leaking or narrowed heart valves (mitral or aortic valves), or any disease of the heart that either results in weakening or stiffening of the heart muscle (cardiomyopathy).

• Shortness of breath
• Difficulty breathing
• Feeling of "air hunger" or "drowning"
• Grunting or gurgling sounds with breathing
• Wheezing
• Shortness of breath with lying down -- you may need to sleep with your head propped up or use extra pillows
• Cough
• Anxiety
• Restlessness
• Excessive sweating
• Pale skin

• Nasal flaring
• Coughing up blood
• Inability to speak
• Decrease in level of awareness

The health care provider will perform a physical exam and use a stethoscope to listen to the lungs and heart. You may have:

• Rapid breathing
• Increased heart rate
• Crackles in the lungs or abnormal heart sounds
• Pale or blue skin color

Possible tests include:

• Blood oxygen levels -- low in patients with pulmonary edema
• Chest x-ray -- may reveal fluid in or around the lung space or an enlarged heart
• Ultrasound of the heart (echocardiogram) -- may show a weak heart muscle, leaky or narrow heart valves, or fluid surrounding the heart

Oxygen is given through a face mask or tiny plastic tubes (prongs) placed in the nose. A breathing tube may be placed into the windpipe (trachea). A breathing machine (ventilator) may be needed.

The cause of the edema should be rapidly identified and treated. For example, if a heart attack has caused the condition, the heart must be treated and stabilized.

Diuretics, such as furosemide (Lasix) may be given to help excess water pass through the urine. Medications to strengthen the heart muscle or to relieve the pressure on the heart may also be given.

Although pulmonary edema can be a life-threatening condition, it can be treated. How well a patient does depends on what is causing the edema.

Some patients may need to use a breathing machine for a long time.

Go to the emergency room or call 911 if you have breathing problems.

If you have a disease that can lead to pulmonary edema, you should be sure to take all medicines as instructed. Following a healthy diet, one usually low in salt, can significantly decrease your risk of this condition.