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What is Pulmonary Edema?

By HERWriter
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Pulmonary edema happens when fluid builds up in the air pockets (alveoli) of the lungs. This fluid impairs the oxygen/carbon dioxide exchange process described in my emphysema article. Pulmonary edema usually occurs as a result of heart problems particularly heart failure where blood pressure increases in the lungs and fluid pushed into the air pockets in the lungs.

The Causes of Pulmonary Edema

Conditions such as pneumonia can also result in pulmonary edema, as well as direct physical injury to the lung. Exercising at very high altitudes can also cause pulmonary edema (www.nlm.nih.gov). Pulmonary edema may appear as a side effect of a heart attack, leaking or narrow heart valves, or any other disease of the heart (such as cadiomyopathy) that results in the weakening or stiffening of the heart muscle.

Other conditions that may result in pulmonary edema include:

  • Acute respiratory distress syndrome where the structural integrity of the alveoli is compromised because of severe infections, trauma, injury to the lungs, inhalation of toxins, lung infections, cocaine smoking, or radiation to the lungs.
  • Kidney failure which compromises the body's ability to cleanse itself of excess fluid
  • Trauma to the brain resulting in intracranial hemorrhage (bleeding), severe seizures, or surgery can correspondingly result in "neurogenic" pulmonary edema
  • When a lung collapses (pneumothorax) or a large amount of fluid around the lung (pleural effusion) is removed and the lung expands rapidly, the affected side may experience pulmonary edema
  • Overdosing on Aspirin, or those who habitually take a high dose of Aspirin may lead to Aspirin intoxication and pulmonary edema.
  • Other conditions include: heroin or methadone overdose, pulmonary embolism, transfusion-related acute lung injury, some viral infections, or eclampsia in pregnant women
  • Symptoms

    There is a long list of symptoms associated with pulmonary edema including (this list compiled from www.nlm.nih.gov and www.mayoclinic.com):

  • Anxiety
  • Cough
  • Difficulty breathing
  • Profuse sweating
  • Feeling of "air hunger" or "drowning"
  • Grunting or gurgling wounds with breathing
  • Pale skin
  • Restlessness
  • Shortness of breath with activity or at rest
  • Wheezing
  • Coughing up blood or frothy mucus that may be tinged with blood (usually pink in color)
  • Decrease in alertness
  • Inability to speak in full sentences
  • Nasal flaring
  • Chest pain if the pulmonary edema is caused by heart disease
  • Palpitations (rapid, irregular heartbeat)
  • If your symptoms come on suddenly, your condition may be life-threatening. Seek medical attention immediately if you experience any of these symptoms:

  • Trouble breathing or a feeling of suffocating
  • A bubbly, wheezing or gasping sound when you breathe
  • Pink, frothy sputum when you cough
  • A blue or gray tone to your skin
  • A severe drop in blood pressure
  • A sudden worsening of any other existing symptoms
  • How Pulmonary Edema is Diagnosed

    Diagnosis starts with a basic, physiological examination by your doctor. A simple stethoscope allows your doctor to listen to the lungs and heart. He/She will be able to hear:

  • Crackling in the lungs (rales)
  • Abnormal heart sounds and rhythms
  • Increased heart rate
  • Rapid breathing
  • These symptoms in addition to cyanosis or discoloring of the skin may lead to further tests which include blood work to examine the red/white cell count, kidney function, blood oxygen levels, and other blood issues. A chest X-ray may also be taken to evaluate for build up of fluid and whether the heart has become enlarged, in addition to an echocardiogram (ultrasound of the heart) that will determine whether there are any structural issues with the heart that could be causing the symptoms.


    Treatment usually takes the form of oxygen through a face mask or prongs placed in the nose. In extreme cases, a breathing tube may be inserted through the trachea and the patient hooked up to a ventilator.

    Once the exact cause of the pulmonary edema has been determined then that will be treated as well.

    Water pills may be given to help flush away excess fluids, as well as medications to strengthen the heart muscle, control the rhythm, or relieve pressure on the heart.


    Since cardiovascular disease is the leading cause of pulmonary edema it is imperative that you engage in life habits that will prevent cardiovascular disease. If you already have cardiovascular disease, it is imperative that you keep it well managed and under control by:

  • Controlling your blood pressure - Have your blood pressure checked regularly. Monitor your blood pressure (120/80 is considered normal at rest). Maintain a healthy lifestyle of regular exercise, a diet rich in fresh fruits, vegetables and low-fat dairy products, and cutting back on salt and alcohol.
  • Monitor and manage your cholesterol levels - While your body does require some cholesterol, too much can result in fatty deposits collecting in arteries, which impedes blood flow and increases the chance of high blood pressure. Limit you intake of fatty foods and increase your intake of fiber, fish, and fresh fruits.
  • Stop smoking - Smoking increases your risk of a second attack or heart-related death, as well as increasing your risk of lung cancer and emphysema. Secondhand smoke can be a contributing factor to coronary artery disease.
  • Eat a heart-healthy diet - including omega-3 fatty acids, fiber, fruits and vegetables and avoiding or limiting your intake of animal fats (saturated) and trans fats (hydrogenated oils).
  • Limit your salt intake - This is more than cutting back on sprinkling salt on foods. Many pre-packaged foods or instant foods, even condensed soups and frozen "fresh" meat such as chicken breasts, are convenient, but are loaded with sodium. Getting back in the habit of preparing fresh meals will cut out a lot of your sodium. Without sodium, however, we lose vital iodine, so eliminating salt altogether is not necessarily a good thing either. Studies show that much of the salt that used in manufactured foods is non-iodized salt, so cut back on the pre-packaged foods and watch how much "table salt" you add to your foods, but don't eliminate it entirely.
  • Exercise regularly
  • Maintain a healthy weight
  • Talk to your doctor about taking a baby Aspirin a day
  • Effectively manage stress - Rethink workaholic tendencies and find effective ways to de-stress.

    Sources: www.mayoclinic.com; www.nlm.nih.gov (U.S. National Library of Medicine and the National Institutes of Health); www.medicinenet.com; www.healthline.com

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    We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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