What is a Pulmonary Edema?

Pulmonary edema is when your lungs fill with fluid. This can happen when your heart is not able to pump blood properly, or when there is damage to the lungs themselves. The main symptoms of pulmonary edema include difficulty breathing, irregular heartbeat, and fatigue. If left untreated, pulmonary edema can be fatal.

Types of Pulmonary Edema

There are two main types of pulmonary edema: cardiogenic and non-cardiogenic. 

Cardiogenic pulmonary edema is caused by an increase of stress in the heart, which can be due to a variety of conditions. Non-cardiogenic pulmonary edema is caused by sources other than heart issues. This type of pulmonary edema is usually due to direct injury to the lung tissue.

Signs & Symptoms

Pulmonary edema signs and symptoms vary in intensity for acute, chronic, and high-altitude pulmonary edema. Symptoms also vary by type of pulmonary edema.

Common signs of pulmonary edema include:

• Difficulty breathing
• Abnormal heartbeat
• Fatigue
• Coughing
• Cold and clammy skin
• Lightheadedness

Acute Pulmonary Edema

Acute pulmonary edema symptoms constitute an emergency. Immediate medical care is strongly recommended. Symptoms include the sudden onset of severe breathing problems, anxiety, and rapid heartbeat.

Chronic Pulmonary Edema

Chronic pulmonary edema symptoms occur over a longer period. You might gain weight, get swollen legs or feet, and experience more trouble breathing when you physically exert yourself.

Chronic pulmonary edema symptoms can also be called mild pulmonary edema signs.

High-Altitude Pulmonary Edema

High-altitude pulmonary edema usually occurs when you go higher than 8,000 feet.

High-altitude pulmonary edema symptoms include the development of a hacking cough, increased production of phlegm, and difficulty breathing. As the condition worsens, you may experience chest pain, an irregular heart rhythm, extreme fatigue, and trouble walking.

Causes

There are two main pulmonary edema causes. These causes include heart issues and pressure on your lungs.

Blood vessels connect your heart and lung. An interruption of blow flow between the heart and lung often results in an accumulation of fluid. Over time, this accumulation leads to increased compression in your lungs.

The main causes of pulmonary edema include:

• Weakened left heart ventricle—This is one of the most common causes of pulmonary edema. When the left ventricle doesn't properly pump blood, fluid leaks from your blood vessels and into your air spaces.
• Drug reaction—Certain medications can cause pulmonary edema. For example, an overdose on opioids.
• Toxins—Exposure to chemicals such as chlorine and ammonia can lead to pulmonary edema.
• Blood clots—Blockages in the blood vessels can result in a build-up of fluid that can damage the lungs.
• Near drowning—A near-drowning can also lead to fluid in the lungs. This is because when you're underwater, your lungs fill with water instead of air.
• Infections—Viral infections such as the flu can also cause pulmonary edema. Pneumonia is another infection that can lead to fluid in the lungs.
• Acute respiratory distress syndrome (ARDS)—This is a condition that can occur after a severe injury or infection. It's characterized by fluid leaking into the air spaces of the lungs.
• Smoke inhalation—Breathing in smoke can damage your lungs and lead to fluid buildup.
• High altitudes—If you ascend to a high altitude too quickly, it can result in damage to your lungs. This is because there's less oxygen at high altitudes, which can lead to an excess burden on your lungs.
• Brain surgery—Surgery or injury to the brain or head is connected to pulmonary edema.
• Sepsis—This is a life-threatening condition that occurs when an infection spreads throughout the body. Sepsis is also known as blood poisoning.
• Blocked airway—An obstructed airway can place stress on your lungs and prevent enough oxygen from reaching your blood.

Cardiogenic Pulmonary Edema

Cardiogenic pulmonary edema is caused by heart valve issues, myocardial infarction, or arrhythmias. This type of pulmonary edema typically occurs when fluid spills out of blood vessels in your lungs and accumulates in the air spaces. 

Noncardiogenic Pulmonary Edema

Noncardiogenic pulmonary edema is not caused by heart problems. Causes of this type of pulmonary edema are infection, blood clots, viral infections, or exposure to toxins.

Risk Factors

Certain individuals are more at risk for developing pulmonary edema. The most common risk factor is heart trouble.

Other pulmonary edema risk factors:

• Heart failure
• Blood disorders
• Obesity
• Smoking
• Exposure to toxics
• Mountain climbing
• Recreational drug use
• History of lung conditions
• History of pulmonary edema

Diagnosis

There are several different ways to diagnose pulmonary edema, and the most appropriate method will depend on the severity of the condition and the individual patient's symptoms.

Pulmonary edema diagnosis tests:

• Standard physical exam—Your doctor will conduct a physical exam, which includes exploring your symptoms and medical history.
• Blood tests—Blood tests can exclude other conditions and provide your doctor with your oxygen levels.
• Electrocardiogram—An electrocardiogram can help your doctor detect heart problems that may be causing your pulmonary edema.
• Echocardiogram—An echocardiogram uses sound waves to produce an image of your heart. This test can help your doctor determine if your heart is pumping properly.
• X-Ray—Your doctor may take a chest X-ray to identify fluid accumulation. An X-ray can also reveal damage to your heart, blood vessels, or lungs.

Treatment

Pulmonary edema is treated with oxygen, reducers, heart medications, and mechanical ventilation. The treatment depends on the severity of the case. In mild cases, treatment may involve receiving oxygen through a mask. More severe cases require hospitalization and ongoing intensive care.

The most common treatment for pulmonary edema:

• Emergency oxygen—Your doctor might deliver oxygen to your lungs through a medical mask.
• Reducers—There are two main types of reducers: preload and afterload. Preload reducers relieve pressure on your lungs. Afterload reducers relieve pressure on your heart.
• Heart medications—Your doctor may prescribe medication to lower blood pressure, reduce vein and artery compression, and manage your pulse.
• Mechanical ventilation—In some cases, your doctor may need to mechanically ventilate your lungs. This is done with a machine that helps you breathe. The machine either delivers oxygen through a breathing mask or breathing tube.

Complications

Pulmonary edema can be a serious condition that can lead to death. It is important to seek medical attention if you think you or someone you know may have pulmonary edema. 

Some of the potential complications of pulmonary edema include:

• Respiratory failure
• Swollen abdomen
• Swollen legs
• Swollen feet
• Ongoing heart trouble
• High blood pressure
• Fatality

Prevention

There is no known way to completely prevent the development of pulmonary edema. You can take action to improve your health and reduce the likelihood of experiencing this condition.

Pulmonary edema prevention methods include:

• Stop smoking
• Avoid recreational drug use
• Avoid high altitudes
• Limit toxin exposure
• Maintain healthy weight
• Eat a healthy diet
• Get vaccinated
• Consistent medical checkups