Pulmonary Edema – What it is, Symptoms and Treatments

Pulmonary Edema – What it is, Symptoms and Drug Treatments. Also, Pulmonary Edema is a condition caused by excess fluid in the lungs . This fluid builds up in the numerous air sacs in the lungs , making breathing difficult. In most cases, heart problems cause Pulmonary Edema . But fluid can build up for other reasons, including pneumonia, exposure to certain toxins and medications, trauma to the chest wall, and exercise or living at high elevations. Pulmonary Edema that develops suddenly ( Acute Pulmonary Edema ) is a medical emergency that requires immediate care.

While Pulmonary Edema can sometimes be fatal, the outlook improves when you get prompt treatment for Pulmonary Edema along with treatment for the underlying problem. Treatment for Pulmonary Edema  varies depending on the cause, but usually includes supplemental oxygen and medications. Pulmonary Edema is an abnormal buildup of fluid in the lungs , which can lead to shortness of breath.

Causes of Pulmonary Edema: Pulmonary  Edema is usually caused by heart failure, which leads to increased pressure in the pulmonary veins. As the pressure in these blood vessels increases, fluid is pushed into the air spaces of the lungs , called alveoli. This accumulated fluid interrupts the normal flow of oxygen in the lungs , resulting in shortness of breath. Other heart conditions can lead to Pulmonary Edema as well:

  • Heart attack
  • Leaking or narrowing of the heart valves (mitral or aortic valves)
  • Any heart disease that results in weakening or stiffening of the heart muscle (cardiomyopathy)
  • coronary artery disease
  • Hypertension

But  Pulmonary Edema can also be caused by other reasons. Look:

  • Lung injuries caused by poisonous gases or serious infections
  • some medicines
  • serious injuries
  • Renal insufficiency
  • Exercises at extreme altitudes

Symptoms of Pulmonary Edema:  Depending on the cause, symptoms of Pulmonary Edema may appear suddenly or develop over time. The (acute) symptoms of Pulmonary Edema are:

  • Extreme shortness of breath or difficulty breathing (dyspnea) that worsens when lying down
  • A feeling of suffocation or drowning
  • wheezes or sighs
  • Anxiety, restlessness, or a feeling of apprehension
  • Cough that produces frothy sputum that can be tinged with blood
  • Chest pain if the Pulmonary Edema is caused by heart disease
  • A fast, irregular heartbeat (palpitations)

If you develop any of these signs or symptoms, call emergency medical care right away. Pulmonary Edema can be fatal if left untreated. Symptoms of Prolonged (chronic) Pulmonary Edema :

  • Having more shortness of breath than usual when you are physically active.
  • Difficulty breathing with effort.
  • Difficulty breathing when upset.
  • wheezes.
  • Waking up at night with a feeling of breath that can be relieved by sitting.
  • Rapid weight gain when Pulmonary Edema develops as a result of congestive heart failure, a condition where your heart pumps too little blood to meet your body’s needs. Weight gain is the buildup of fluid in your body, especially in your legs.
  • Swelling in the lower extremities.
  • Fatigue.

Symptoms of High Altitude Pulmonary Edema are:

  • Shortness of breath after exertion, which progresses to shortness of breath at rest
  • Cough
  • Difficulty walking uphill, which advances to make walking on flat surfaces difficult
  • Fever
  • Cough that produces frothy sputum that can be tinged with blood
  • A fast, irregular heartbeat (palpitations)
  • chest discomfort
  • Headaches , which may be the first symptom

When to See a Doctor:  Pulmonary Edema that occurs suddenly ( Acute Pulmonary Edema ) is fatal. Get emergency assistance if you have any of the following acute signs and symptoms:

  • Shortness of breath, especially if it comes on suddenly
  • Breathing problems or a feeling of suffocation (dyspnea)
  • A bubbling, hissing or gasping sound when you breathe
  • Pink, foamy sputum when coughing
  • Difficulty breathing along with profuse sweating
  • A blue or gray tone to your skin
  • A significant drop in blood pressure, resulting in lightheadedness, dizziness, weakness, or sweating
  • Sudden worsening of any of the symptoms associated with Chronic Pulmonary Edema or High Altitude Pulmonary Edema

Do not try to drive yourself to the hospital. Instead, call emergency medical care and wait for help.

Complications of Pulmonary Edema:  If Pulmonary Edema continues, it can increase the pressure in the pulmonary artery (pulmonary hypertension) and eventually the right ventricle in your heart becomes weak and begins to fail. The right ventricle has a much thinner wall of muscle than the left side of the heart because it is under less pressure to pump blood into the lungs . The increased pressure back into the right atrium and then into various parts of your body, where it can cause:

  • Lower extremity and abdominal swelling
  • Buildup of fluid in the membranes surrounding your lungs (pleural effusion)
  • Congestion and swelling of the liver

When left untreated, acute pulmonary edema can be fatal. In some cases, it can be fatal even if you get treatment.

Pulmonary Edema Testing and Diagnosis:  As Pulmonary Edema requires prompt treatment, you will initially be diagnosed based on your symptoms and physical examination, electrocardiogram, and chest X-ray. Once your condition is more stable, your doctor will ask about your medical history, especially if you’ve had cardiovascular  or lung disease. Tests that may be done to diagnose Pulmonary Edema or to determine why you have developed fluid in your lungs  include:

  • Chest X-ray:  A chest X-ray will likely be the first test you have performed to confirm the diagnosis of Pulmonary Edema and exclude other possible causes of shortness of breath.
  • Pulse Oximetry:  In pulse oximetry, a sensor attached to your finger or ear uses light to determine the amount of oxygen in your blood.
  • Bloodtests. You may have blood drawn, usually from an artery in your wrist, so that you can check how much oxygen and carbon dioxide it contains (arterial blood gas concentrations). Your blood may also be checked for levels of a substance called B-type natriuretic peptide (BNP). Rising levels of BNP may indicate that your Pulmonary Edema is caused by a heart condition. Other blood tests may be done — including tests of your kidney function, thyroid function, and blood count — as well as tests to rule out a heart attack as a cause of Pulmonary Edema .
  • Electrocardiogram (ECG). This non-invasive test can reveal a wide range of information about your heart. During an ECG, patches attached to your skin receive electrical impulses from your heart. These are recorded in the form of waves on graph paper or a monitor. The wave patterns show your heart rate and rhythm and whether areas of your heart have decreased blood flow.
  • Echocardiogram. An echocardiogram is a non-invasive test that uses a wand-shaped device called a transducer to generate high-frequency sound waves that are reflected by the heart’s tissues. The sound waves are then sent to a machine that uses them to compose images of your heart on a monitor. The test can help diagnose a number of heart problems, including heart valve problems, abnormal movements of the ventricular walls, fluid around the heart (pericardial effusion), and congenital heart defects. It can also show areas of decreased blood flow to your heart and whether your heart pumps blood effectively when it beats. It can also estimate whether there is increased pressure in the right side of the heart and increased pressure in the pulmonary arteries.
  • Trans Esophageal Echocardiography (TEE). In a traditional cardiac ultrasound exam, the transducer remains outside the body on the chest wall. But in TEE, a doctor inserts a soft, flexible tube (catheter) with a transducer attached to the tip through your mouth and guides it down your esophagus — the passageway that leads to your stomach. The esophagus is immediately behind your heart, which allows your doctor to see a closer, more accurate picture of the heart and central pulmonary arteries.
  • Pulmonary artery catheterization. If other tests don’t reveal the reason for Pulmonary Edema , your doctor may suggest a procedure to measure the pressure in your lung capillaries (wedge pressure). During this test, a doctor inserts a small balloon-tipped catheter through a vein in your leg or arm and guides it into a pulmonary artery. The catheter has two openings connected to pressure transducers. The balloon is inflated and then deflated, giving pressure readings.
  • Cardiac catheterization. If tests, such as an ECG or echocardiogram, do not reveal the cause of Pulmonary Edema, or you also have chest pain, your doctor may suggest cardiac catheterization and coronary angiography. During cardiac catheterization, a doctor inserts a long, thin catheter into an artery or vein in your groin, neck, or arm and passes it through your blood vessels to your heart using X-ray imaging. Doctors then injected dyes into your heart’s blood vessels to make them visible under X-ray images (coronary angiography). During this procedure, doctors may perform treatments, such as opening a blocked artery, which can quickly improve the pumping action of the left ventricle. Cardiac catheterization can also be used to measure pressure in your heart chambers, assess your heart valves, and look for causes of Pulmonary Edema .

Pulmonary Edema Treatments:  Giving oxygen is the first step in treating Pulmonary Edema . You usually receive oxygen through a face mask or nasal cannula – a flexible plastic tube with two openings that deliver oxygen to each nostril. This should alleviate some of your symptoms.

Your doctor will monitor your oxygen level closely. Sometimes it may be necessary to assist your breathing with a machine, such as a mechanical ventilator. Depending on your condition and the reason for Pulmonary Edema , you may also be given one or more of the following medications:

  • Preload reducers. Preload-reducing medications decrease the pressure caused by fluid entering the heart and lungs . Doctors commonly prescribe nitroglycerin and diuretics like furosemide (Lasix) to treat pulmonary edema . Diuretics can make you urinate so much initially that you may temporarily need a urinary catheter while you are in the hospital. The drug nifedipine (Procardia) may sometimes be prescribed.
  • Morphine (Avinza, MS Contin). This narcotic can be used to relieve shortness of breath and anxiety. But some doctors believe the risks of morphine may outweigh the benefits and are more likely to use other, more effective drugs.
  • Afterload reducers. These medications, such as nitroprusside (Nitropress), dilate your blood vessels and take a pressure load out of your heart’s left ventricle.
  • Blood pressure medications. If you have high blood pressure when you develop pulmonary edema , you will be given medication to control it. Alternatively, if your blood pressure is very low, you are likely to be given medication to raise it.

If your Pulmonary Edema is caused by another condition, such as a nervous system condition, your doctor will treat the condition causing it and the pulmonary edema . Some climbers are given prescription drugs such as acetazolamide (Diamox Sequels) or nifedipine to help treat or prevent symptoms of HAPE. To prevent HAPE, medication is started at least one day before ascent. The most commonly used drugs for the treatment of pulmonary edema are:

  • aminophylline
  • acetylcysteine
  • Aires
  • bricanyl
  • Ipratropium bromide
  • Fenoterol hydrobromide
  • Betamethasone
  • brondilat
  • Celestone
  • dobutamine
  • Fluimucil
  • Fluimucil (syrup)
  • foraseq
  • ipratropium

Only a doctor can tell you which drug is most suitable for you, as well as the correct dosage and duration of treatment. Always follow your doctor’s instructions to the letter and never self-medicate. Do not stop using the drug without consulting a doctor first, and if you take it more than once or in much larger amounts than prescribed, follow the instructions on the package insert.

Prevention of Pulmonary Edema: Pulmonary  Edema is not always preventable, but these measures can help reduce your risk. Cardiovascular disease is the main cause of Pulmonary Edema . You can reduce your risk of many types of heart problems by following these suggestions:

  • Control your blood pressure. High blood pressure (hypertension) can lead to serious conditions like stroke, cardiovascular disease and kidney failure. In many cases, you can lower your blood pressure or maintain a healthy level by getting regular exercise; Maintaining a healthy weight; Eating a diet rich in fresh fruits, vegetables and low-fat dairy products; And limiting salt and alcohol.
  • Cuidado com o colesterol no sangue. O colesterol é um dos vários tipos de gorduras essenciais para uma boa saúde. Mas o colesterol demais pode ser muito bom. Níveis de colesterol superiores ao normal podem causar depósitos de gordura na sua artéria, impedindo o fluxo sanguíneo e aumentando seu risco de doença vascular. Mas mudanças de estilo de vida muitas vezes podem manter seus níveis de colesterol baixos. As mudanças de estilo de vida podem incluir gorduras limitantes (especialmente gorduras saturadas); Comendo mais fibra, peixe e frutas e vegetais frescos; Exercitando regularmente; Parar de fumar; E beber com moderação.
  • Do not smoke. If you smoke and can’t quit on your own, talk to your doctor about strategies or programs to help you break a smoking habit. Smoking can increase your risk of cardiovascular disease . Also avoid secondhand smoke.
  • Maintain a healthy weight. A healthy diet low in salt, sugars and solid fats and high in fruits, vegetables and whole grains.
  • Salt limit. It is especially important to use less salt (sodium) if you have heart disease or high blood pressure. In some people with severely impaired left ventricular function, too much salt can be enough to trigger congestive heart failure. If you’re having a hard time cutting back on salt, it might help to talk to a nutritionist. He or she can help point out foods that are low in sodium, as well as offer tips for eating a low-salt, good-tasting diet.
  • Exercise regularly. Exercise is vital for a healthy heart. Regular aerobic exercise, about 30 minutes a day, helps control blood pressure and cholesterol levels and maintain a healthy weight. If you’re not used to exercising, start slowly and build up gradually. Make sure your doctor is okay before starting an exercise program.
  • Maintain a healthy weight. Being even slightly overweight increases your risk of cardiovascular disease . On the other hand, even small amounts of weight loss can lower blood pressure and cholesterol and reduce the risk of diabetes.
  • Manage stress. To reduce your risk of heart problems, try to reduce your stress levels . Find healthy ways to minimize or deal with stressful events in your life.

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