Pulmonary Edema

What Is Pulmonary Edema?

Pulmonary edema is a buildup of fluid in your lungs. That can make it hard for you to breathe.

When you take a breath, your lungs should fill with air. If you have pulmonary edema, they fill with fluid instead. When that happens, oxygen from the air can’t get from your lungs into your blood, where it’s needed.

 

Pulmonary Edema Symptoms

Acute pulmonary edema comes on suddenly and can be life-threatening. If you have any of these symptoms, call 911 right away:

  • Sudden shortness of breath, especially after activity or while lying down
  • Feeling like you’re drowning or your heart is dropping
  • Anxiety
  • Trouble breathing with a lot of sweating
  • Breathing that sounds bubbly, wheezing, or gasping
  • Coughing up pink, frothy spit
  • Skin that’s cold and clammy or looks blue or gray
  • A rapid, uneven heartbeat (palpitations)
  • Feeling lightheaded, dizzy, weak, or sweaty, which can signal a drop in blood pressure

When the problem happens over time, it’s called chronic pulmonary edema. You may:

  • Be tired
  • Gain weight rapidly (this may be a sign of fluid buildup and congestive heart failure)
  • Have more breathing problems than usual when you’re active
  • Have swollen legs and feet
  • Have trouble breathing when lying down
  • Wake up at night with a breathless feeling that gets better if you sit up
  • Wheeze

 

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Pulmonary Edema Causes

There are two main kinds of pulmonary edema: cardiogenic and noncardiogenic.

Cardiogenic pulmonary edema

This type is caused by a problem with your heart.

In many cases, your left ventricle (one of the chambers of your heart) isn’t able to pump out blood that enters through blood vessels from your lung. This creates a buildup of pressure and fluid.

Narrow arteries, heart muscle damage, heart valve problems, and high blood pressure are among the conditions that can weaken your left ventricle.

Noncardiogenic pulmonary edema

This type isn’t related to heart problems. Other causes include:

  • Acute respiratory distress syndrome (ARDS)
  • Blood clots
  • Brain surgery or conditions such as seizures and head injuries
  • High pressure in your chest after your airway is blocked
  • Contact with ammonia, chlorine, or other toxins
  • Inhaling smoke that has certain chemicals
  • Lung injury after removal of blood clots
  • Near-drowning 
  • Reaction to some drugs, including aspirin
  • Opioid overdose
  • Blood transfusion
  • Viral infections
  • Pneumonia
  • Blood poisoning or sepsis

Pulmonary edema also can be brought on from being in high altitudes, usually above 8,000 feet. Mountain climbers should get to lower ground and seek medical attention if they have:

  • Chest discomfort
  • Cough
  • Cough with frothy spit that may have some blood in it
  • Fast, irregular heartbeat
  • Fever
  • Headache
  • Shortness of breath when they’re active that gets worse over time
  • Trouble walking uphill that leads to trouble walking on a flat surface

 

Pulmonary Edema vs. Pleural Effusion vs. Pneumonia

It’s easy to get pulmonary edema mixed up with some other lung conditions.

Pleural effusion

Unlike pulmonary edema, in which fluid collects inside your lungs, pleural effusion is when it builds up in the layers of tissue that line the outside of your lungs and the inside of your chest. Symptoms include chest pain, shortness of breath, and a dry cough. It can be caused by problems like heart failure, blood clots, pneumonia, kidney disease, and tuberculosis.

Pneumonia

Pneumonia also leads to fluid buildup in the tiny air sacs in your lungs, but it’s caused by an infection with a virus, bacteria, or fungus. Symptoms include chest pain, coughing, fatigue, a fever, shortness of breath, and stomach problems. Pneumonia can sometimes cause pulmonary edema.

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Pulmonary Edema Diagnosis

To help your doctor find out what’s going on, you may need to:

  • Answer questions about your medical history
  • Have a physical exam
  • Get a chest X-ray so the doctor can study your heart and lungs
  • Have heart tests to measure how well your heart beats
  • Have a blood test to find out how much oxygen and carbon dioxide are in your blood

Pulmonary Edema Treatment

If you’re having trouble breathing and your oxygen level is low, you’ll get oxygen right away. You may get it through a face mask, or with tubes put inside your nostrils.

Your treatment will depend on what’s causing your pulmonary edema. Whether it’s your heart, medication, or an illness, your doctor will try to deal with the problem that brought it on.

The doctor may prescribe medicine such as a diuretic to lower the pressure on your heart and lungs.

Pulmonary Edema Prevention

Some lifestyle changes can prevent pulmonary edema or help keep the condition in check. Keep your heart healthy by:

If you’re going somewhere at a higher elevation, try to get used to the altitude change slowly. Talk to your doctor about medications that might make you less likely to get high-altitude pulmonary edema.

WebMD Medical Reference Reviewed by James Beckerman, MD, FACC on April 30, 2020

Sources

SOURCES:

Mayo Clinic: "Pulmonary Edema."

American Heart Association: "Types of Heart Failure."

Up to Date: "Noncardiogenic Pulmonary Edema."

Medscape: "Cardiogenic Pulmonary Edema Treatment & Management."

StatPearls: “Cardiogenic Pulmonary Edema.”

Intensive Care Medicine: “Understanding negative pressure pulmonary edema.”

International Journal of Clinical and Experimental Medicine: “Analysis of risk factors of secondary pulmonary edema during fluid resuscitation in sepsis patients.”

Cleveland Clinic: “Pleural effusion.”

Mayo Clinic: “Pneumonia.”

 

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