What Is Pulmonary Edema?
Pulmonary Edema is a medical condition in which there is excess fluid buildup in the lungs which makes it extremely difficult to breathe and causes severe shortness of breath. Majority of the cases of Pulmonary Edema are caused by cardiac conditions but there may be other conditions which can cause fluid buildup in the lungs as well which includes conditions like pneumonia, certain classes of medications, or chronic exposure to certain toxins. A direct blow or trauma to the chest wall can also be a cause of Pulmonary Edema. An individual living in high altitudes or mountaineers can also develop Pulmonary Edema due to lack of oxygen. Pulmonary Edema requires emergent medical treatment to prevent serious complications. The treatment options for Pulmonary Edema depend on the cause of the problem and normally include oxygen supplementation and medications.
What Causes Pulmonary Edema?
Pulmonary Edema is basically divided into two broad categories which are cardiogenic Pulmonary Edema and non-cardiogenic Pulmonary Edema and the causes of these two types are also different.
Some of the causes of Cardiogenic Pulmonary Edema are:
Pulmonary Edema which is caused as a result high pressure in the blood vessels of the lungs as a result of poor functioning of the heart. Certain medical conditions like Congestive heart failure, heart attacks, abnormality of the heart valves can all cause abnormal collection of fluid in the vessels of the lungs thus increasing the pressure in the vessels of the lungs causing Pulmonary Edema.
Causes of Non-cardiogenic Pulmonary Edema:
Non-cardiogenic Pulmonary Edema can be caused due to the following:
- Acute Respiratory Distress Syndrome: This is quite a serious medical condition which is caused by infections, direct trauma to the lungs, injury to the lungs, chronic inhalation of toxins, and smoking.
- Renal Dysfunction: Kidney dysfunction is also one of the causes of Pulmonary Edema. As the body is unable to excrete excess fluids from the body due to kidney dysfunction it causes excess buildup of fluid which can put pressure on the vessels resulting in Pulmonary Edema.
- People staying in high altitudes and frequent mountaineers are prone to Pulmonary Edema due to reduction in oxygen levels which outs oppressure in the vessels of the lungs causing Pulmonary Edema.
- Serious conditions like intracranial hemorrhage, seizure disorder, or a surgical procedure of the brain can sometimes result in Pulmonary Edema.
- Conditions like pneumothorax or pleural effusion can also cause Pulmonary Edema.
- Some of the rare causes of Pulmonary Edema are pulmonary embolism, lung injury due to transfusion, or viral infections.
What Are The Symptoms Of Pulmonary Edema?
Some of the symptoms of acute Pulmonary Edema are:
- Severe dyspnea which worsens with lying down
- Suffocating feeling
- Feeling of gasping for breath
- Severe anxiety and restlessness
- Persistent cough that may be tinged with blood
- Chest pain in case there is a cardiac cause for Pulmonary Edema
- Heart palpitations.
Some of the symptoms of chronic Pulmonary Edema are:
- Severe dyspnea at rest or with activity which worsens with lying flat
- Breathlessness when sleeping at night which interferes with sleep
- Sudden weight gain
- Lower extremity edema
- Excessive fatigue.
Some of the symptoms of Pulmonary Edema due to increased altitudes are:
- Dyspnea with rest and with activity
- Persistent cough
- Difficulty walking uphill at first which gradually progresses to walking difficulties even on normal surfaces
- Persistent fever
- Severe cough
- Heart palpitations
- Chest discomfort
How Is Pulmonary Edema Diagnosed?
Since Pulmonary Edema is a potentially serious condition and needs emergent treatment hence it is vital to diagnose the condition appropriately. In order to do that the physician will first take a detailed history as to when the symptoms started and how long has the individual been feeling the symptoms. The physician will then conduct a physical examination starting with auscultation of the lungs looking for any wheezing. Once Pulmonary Edema is suspected then the physician will order the following tests in order to confirm the diagnosis:
Echocardiogram: This test makes use of ultrasound waves to look at the functioning of the heart. This test can accurately identify any abnormality of the functioning of the heart.
Transesophageal Echocardiogram: This is a form of echocardiogram in which images of the heart are obtained through a transducer that is inserted into the esophagus.
Chest X-ray: This can reveal whether there is any enlargement of the heart or not which can rule in or rule out cardiomegaly as a cause of the heart murmur.
Apart from these tests a CT scan or an MRI will also be obtained which can accurately detect presence of Pulmonary Edema.
Pulse Oximetry: This test determines how much oxygen enters the lungs.
Blood tests: Blood tests are done to look at the oxygen levels in the blood.
Pulmonary Artery Catheterization: If all the above tests are inconclusive then the physician may perform this procedure in order to measure the pressure in the capillaries of the lungs. In this procedure, the physician will insert a catheter through a vein in the arm or leg guiding it to the pulmonary artery and pressure is measured
Cardiac Catheterization: This is a minimally invasive test in which a catheter is inserted in the heart through the leg. This test accurately measures the pressure that is exerted on the chambers of the heart.
How Is Pulmonary Edema Treated?
The very first treatment adopted once Pulmonary Edema is diagnosed is to supplement the patient with oxygen. This can be done through a nasal cannula or a face mask. This relieves the symptoms of dyspnea to a great extent. Mechanical ventilation may also be required in some acute cases of Pulmonary Edema. Depending on the acuity of the condition the following treatment measures may be adopted for treatment of Pulmonary Edema:
Medications: Medications like nitroglycerine or Lasix are prescribed to take the pressure off of the heart and lungs and decrease the symptoms of Pulmonary Edema. Lasix may cause you to pass urine frequently as it is a diuretic. Procardia is also recommended in some cases. Morphine is recommended to get rid of dyspnea and anxiety in some cases.
In case of a hypertensive patient who develops Pulmonary Edema medications will prescribed to control both the conditions.
For treatment of Pulmonary Edema caused due to high altitudes, it is recommended that the patient reduce as much physical activity as possible. Oxygen supplementation is the treatment of choice. If enough oxygen supply is not available then hyperbaric chambers can be used until the patient can be brought to a lower altitude with sufficient oxygen availability. Apart from this, Procardia may be prescribed for alleviation of symptoms. It is always preferable to consult with a physician and take preventive medications if you have risk factors for Pulmonary Edema and you are planning to go on the mountains.
What Are The Dos And Don'ts When Having Pulmonary Edema?
If you have Pulmonary Edema it is best to follow the below mentioned things to control the symptoms:
- Maintain strict control of blood pressure in case if you are hypertensive
- Maintain tight control of blood sugars if you are a diabetic
- Control intake of medications which may increase the risk of Pulmonary Edema
- Stay away from alcohol and tobacco
- Maintain a well-balanced healthy diet
- Main an ideal body weight.
Following these measures will not only decrease the risk but also help with the symptoms of Pulmonary Edema.