Pulmonary Edema: Causes, Symptoms, and Treatment

Do you know that pulmonary edema can occur when there is too much fluid in your lungs?

This fluid collects in the sacs of your lungs and makes it difficult to breathe.

In most cases, heart problems can cause pulmonary edema

However, fluid can also collect in your lungs for a number of other reasons.

These can include pneumonia, contact with certain toxins, medications, trauma to the chest wall, and traveling to or exercising at high elevations.

Moreover, pulmonary edema that develops suddenly, i.e. acute pulmonary edema is a medical emergency that needs immediate care.

It can, in some cases, also cause death and you will need prompt treatment help.

Treatment for this condition depends on the cause but in general cases, it includes additional oxygen and medications.

Keep on reading to learn more about it in detail.

Causes of Pulmonary Edema

There are a number of possible causes of pulmonary edema.

Let’s discuss them as follows:

Congestive Heart Failure

The most common cause of pulmonary edema is congestive heart failure, CHS.

Heart failure occurs when your heart can no longer pump blood properly throughout the body.

Moreover, this creates a backup of pressure in the small blood vessels of your lungs and causes the vessels to leak fluid.

In a healthy body, your lungs will take oxygen from the air you breathe and put it into the bloodstream.

However, when fluid fills your lungs, they cannot put oxygen into the bloodstream.

This deprives the rest of your body of oxygen.

Other Medical Conditions

Some other less common medical conditions that can cause pulmonary edema are:

• heart attack or other heart diseases
• leaking, narrowed, or damaged heart valves
• sudden high blood pressurepneumonia

• kidney failure
• lung damage due to severe infection
• severe sepsis of the blood, blood poisoning due to an infection

External Factors

While some external factors that can put extra pressure on your heart and lungs.

These lead to pulmonary edema, and these are:

• high altitude exposure
• illicit drug use or drug overdose
• lung damage due to inhalation of toxins
• severe trauma
• major injury
• near-drowning

Heart-related or Cardiogenic Pulmonary Edema

This type of edema occurs due to an increase in pressure in your heart.

It often occurs as a result of heart failure.

When a diseased or overworked left lower heath chamber or left ventircle is unable to pump out enough blood, it gets from the lungs, and the pressure in the heart goes up.

This increase in pressure pushes fluid through the blood vessel walls into the air sacs.

Certain medical conditions that can cause heart failure and lead to pulmonary edema are:

Coronary Artery Disease: With time, the arteries that supply blood to the heart muscle can become narrow from fatty deposits or plaques

This narrowing of the coronary arteries can weaken the left ventircle.

In some cases, a blood clot in one of these narrowed arteries can block the blood flow and damaged parts of the heart muscle.

This results in a heart attack.

A damaged heart muscle is no longer able to pump as well as it should.

Cardiomyopathy: This means heart damage and with this condition, your heart will pump harder and the pressure rises.

Then your heart may not be able to work harder when needed, like during exercise, when there is an infection or a rise in blood pressure.

When the left ventircle cannot keep up with the demands that it places on it, the fluid backs up into the lungs.

Other Heart-related Conditions

Some of the other heart-related conditions are:

Heart Valve Problem: Narrowing or stenosis of the aortic or mitral heart valves or a valve leak or the one that does not close properly can affect the blood flow into the heart.

Moreover, a valve leak that develops suddenly may cause sudden and severe pulmonary edema.

Hypertension: If you do not get treatment or control high blood pressure, it can enlarge your heart.

Other Heart Problems: Some other heart conditions that can lead to pulmonary edema are:

• inflammation of the heart muscle, or myocarditis
• heart problems present at birth or congenital heart defects
• irregular heart rhythms or arrhythmias

Kidney Disease: Heart blood pressure due to narrowing kidney arteries, i.e. renal artery stenosis or fluid buildup due to kidney disease can cause pulmonary edema.

Chronic Health Conditions: Thyroid disease and a buildup of iron, i.e. hemochromatosis, or protein, i.e. amyloidosis can also contribute to heart failure and cause pulmonary edema.

Non-Heart-related or Noncardiogenic Pulmonary Edema

Pulmonary edema that does not occur due to an increase in pressure in the heart is noncardiogenic pulmonary edema.

The causes of this type of edema are:

Acute Respiratory Distress Syndrome, ARDS: This serious disorder occurs when your lungs suddenly fill with fluid.

A number of conditions can cause ARDS, including:

• injury or trauma
• widespread infection or sepsis
• pneumonia
• severe bleeding

Drug Reaction or Drug Overdose: A number of drugs ranging from aspirin to illegal drugs like heroin and cocaine can cause pulmonary edema.

Pulmonary Embolism or Blood Clot in the Lungs: A blood clot that moves from the blood vessels in the legs to your lungs can cause pulmonary edema.

Exposure to Certain Toxins: Inhaling toxins or breathing in some stomach contents when vomiting, i.e. aspiration can cause intense irritation of the small airways.

And it can also irritate the air sacs, resulting in fluid buildup.

High Altitudes: Pulmonary edema can occur in mountain climbers, skiers, hikers, and others who travel above 8,000 feet or about 2,400 meters.

Moreover, high altitude pulmonary edema, HAPE can occur in those who do not take the days and weeks needed to become used to the elevations.

However, people who live at high altitudes can also get HAPE with no elevation changes if they have a respiratory illness.

Near Drowning: Inhaling water can also lead to fluid buildup in the lungs.

Negative Pressure Pulmonary Edema: A blocked upper airway that causes a negative pressure in the lungs from trying to breathe through the blockage.

With treatment, in most cases, this type of pulmonary edema can be treated in about 24 hours.

Other Conditions that Cause Pulmonary Edema

Some other conditions that can cause pulmonary edema are:

Nervous System Conditions or Surgeries: A type of pulmonary edema i.e. neurogenic pulmonary edema can occur after a head injury, seizure, or brain surgery.

Smoke Inhalation: Smoke from a fire contains chemicals.

These can damage the membrane between the air sacs and the capillaries.

Moreover, the damage allows the fluid to enter the lungs.

Transfusion-Related Lung Injury: Blood transfusion may cause fluid overload in the left ventircle, leading to pulmonary edema.

Viral Illnesses: Viruses like hantavirus and dengue virus can cause pulmonary edema.

Risk Factors leading to Pulmonary Edema

Heart failure and other heart conditions that raise the pressure in your heart can increase the risk of pulmonary edema.

Certain risk factors for heart failure are:

• irregular heart rhythms or arrhythmias
• alcohol use
• congenital heart disease
•  coronary artery disease
• diabetes
• heart valve disease
• high blood pressure
• sleep apnea

Moreover, some nervous system conditions and lung damage that takes place due to near-drowning, drug use, inhaling smoke, viral illnesses, and blood clots can also raise the risk.

People who travel to high-altitude locations above 8,000 feet or about 2,400 meters are more likely to develop high-altitude pulmonary edema, HAPE.

Children who already have pulmonary hypertension and structural heart defects are more likely to get HAPE.

Symptoms of Pulmonary Edema

In case when pulmonary edema is affecting your body, it will struggle to gain oxygen.

This occurs due to the amount of increasing fluid in the lungs preventing oxygen from moving into the bloodstream.

Moreover, symptoms can continue to worsen until you get treatment.

However, some of the symptoms depend on the type of pulmonary edema as well.

Long-term Pulmonary Edema

The symptoms of long-term pulmonary edema are:

• shortness of breath when you are physically active
• difficulty breathing when lying down
• wheezing
• waking up at night with a breathless feeling that goes away when you sit up
• rapid weight gain, especially in the legs
• swelling in the lower part of the body
• fatigue

High-Altitude Pulmonary Edema

Pulmonary edema due to altitude sickness or not getting enough oxygen in the air can cause symptoms like:

Headaches, irregular, rapid heartbeat, shortness of breath after exertion and during rest, coughing, fever, and difficulty walking uphill on flat surfaces.

Moreover, getting emergency assistance in case these symptoms gets worse can help.

However, make sure to avoid driving yourself to the hospital.

Diagnosing Pulmonary Edema

Your doctor will look for fluid in your lungs, or the symptoms it causes due to its presence.

They will also perform a basic physical examination and listen to your lungs with a stethoscope, looking for symptoms like:

• an increased heart rate
• rapid breathing
• a crackling sound from your lungs
• any abnormal heart sounds

Moreover, your doctor will also look at your neck for fluid buildup, legs, and abdomen swelling, and if you have pale or blue-colored skin.

They will discuss your symptoms and ask about your medical history.

However, if they believe you have fluid in your lungs, they will order additional tests.

Examples of tests are:

• complete blood count
• echocardiogram, or an ultrasound to check for abnormal heart activity
• blood tests to check oxygen levels
• electrocardiogram, ECG to look for heart rhythm problems or signs of a heart attack.

Treatment Options

Pulmonary edema is a serious condition that will need quick treatment.

Oxygen is always the first line of treatment for this condition and your healthcare team may prop you and deliver 100% oxygen.

They can do so through an oxygen mask, nasal cannula, or positive pressure mask.

Moreover, your doctor will also diagnose the cause of pulmonary edema and prescribe the appropriate treatment for the underlying cause.

Depending on your condition and the cause of pulmonary edema, your doctor can also give the following:

Preload Reduces

These will help to decrease pressures from the fluid going into your heart and lungs.

Also, diuretics can help to reduce this pressure by making you urinate, which eliminates fluid.

Afterload Reduces

These medications will help to dilate your blood vessels and take pressure off your heart

Heart Medications

Such medications will help to control your pulse, reduce high blood pressure, and relieve pressure in arteries and veins.

Morphine

This narcotic can help relieve anxiety and shortness of breath.

However, fewer doctors today use this medication due to the risks.

In severe cases, people with pulmonary edema will need intensive or critical care.

In other cases, you may need treatment to help you breathe.

A machine can help deliver oxygen under pressure to help you get more air into your lungs.

While in some cases, your doctor can do so with the help of a mask or cannula, i.e. Continous Positive Airway Pressure, CPAP.

Furthermore, your doctor may need to insert an endotracheal tube or breathing tube, down your throat and use mechanical ventilation.

Pulmonary Edema vs. Pleural Effusion

In some cases, pulmonary edema can be confused with pleural effusion.

This is a condition that involves fluid buildup in the lungs.

However, it specifically causes a buildup of fluids in the pleural tissues.

These cover the outside of each of your lungs as well as the inside of your chest wall.

Pleural effusion can occur due to CHF, poor nutrition, and pneumonia. In some cases, it can also be cancerous, or malignant.

With pleural effusion, you can experience the following:

• breathing difficulties
• a dry cough
• shortness of breath
• chest pain and discomfort

With the help of a chest x-ray, your doctor can diagnose pleural effusion.

Moreover, they can take a biopsy from pleural tissues if they suspect cancer.

Depending on the cause, pleural effusion can be treated with a combination of fluid removal techniques and surgery.

Pulmonary Edema vs. Pneumonia

Pneumonia is another serious health condition of the lungs.

Unlike edema, it occurs due to viral, fungal, or bacterial infections.

As your lungs become infected, fluid buildups in the air sacs or alveoli.

While both pulmonary edema and pneumonia can cause a form of buildup in your lungs, the former primarily occurs due to CHF.

However, pneumonia occurs due to infection.

Moreover, a weakened immune system can also increase your chances of getting pneumonia from a common cold or flu.

Symptoms of pneumonia are:

• high fever with chills
• cough with mucus that continues to worsen
• chest pain and discomfort
• shortness of breath
• nausea and/or vomiting
• diarrhea

Furthermore, pneumonia is one of the most common causes of hospitalization in children and adults, according to the American Lung Association.

When you do not get treatment for this condition, it can lead to pleural effusion, lung abscess, respiratory failure, septic shock, and renal failure.

It is important to note that pulmonary edema does not occur due to pneumonia.

However, the buildup of fluids from pneumonia can lead to pleural effusion.

Therefore, pneumonia requires immediate treatment or you should seek medical advice to prevent complications which will need antibiotics and oxygen therapy.

When is it an Emergency?

Make sure to call 911 or your local emergency service immediately for help if you experience any of the following symptoms:

• extreme breathing difficulties or shortness of breath like suffocating or drowning
• inability to breathe
• anxiety-related to trouble breathing
• cough the produces a pink, frothy mix of saliva and mucus
• chest pain
• rapid, irregular heartbeat
• blue or gray skin tone
• sweating along with breathing difficulties

These may be the symptoms of acute pulmonary edema.

It develops suddenly, and if you do not get treatment, the fluid in your lungs can cause you to drown.

Prevention Tips

There is no way to fully prevent pulmonary edema. However, if you are at high risk, you should seek immediate medical attention if you develop symptoms of the disorder.

The best way to try and prevent pulmonary edema is by taking good care of your health.

You can get:

• pneumonia vaccine
• the flu vaccine, especially if you have heart problems or if you are an older adult
• remain on diuretics after an episode of pulmonary edema to prevent a reoccurrence

You can also decrease your risk for heart failure, the most common cause of pulmonary edema with the steps like visiting your doctor regularly, avoiding using recreational drugs and smoking, regular exercises, healthy foods, and maintaining a normal weight.

Outlook

The outlook of pulmonary edema depends on the severity of your case, In case you have a moderate case and receive quick treatment, you will have a full recovery.

However, in severe cases, it can be fatal if you delay the treatment. Make sure to seek medical advice or see your doctor and get immediate help if you experience any of the symptoms of pulmonary edema.