Pulmonary Edema

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KEY POINTS

• Pulmonary edema is a buildup of fluid in the airways of your lungs. The most common cause of pulmonary edema is heart failure. If the condition is not treated, it can be life-threatening.
• Treatment includes oxygen to help you breathe, medicines, and a low salt diet.
• Follow the full course of treatment prescribed by your healthcare provider about medicines, activity, diet, liquids, and not smoking.

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What is pulmonary edema?

Pulmonary edema is a buildup of fluid in the airways of your lungs. The airways are the tubes and sacs that carry air in and out of your lungs. When there is fluid in the airways instead of air and oxygen, it can make it very hard to breathe and is a serious medical problem. If the condition is not treated, it can be life-threatening.

What is the cause?

The most common cause of pulmonary edema is heart failure. Heart failure means the heart is not pumping blood as well as it should. It may pump at a different speed, pump blood with less force, or pump less blood with each heartbeat. When less blood is flowing out of the heart to the body, muscles and other tissues may not get enough oxygen. The kidneys may not work as well to remove excess fluid in the form of urine. As a result, blood backs up into the blood vessels. The extra fluid seeps into the lungs or other parts of the body. Fluid in the lungs makes it hard to breathe. Fluid seeping into other parts of the body causes swelling. When there is too much fluid in the body, it puts more strain on the heart. Heart failure may be caused by:

• Heart valve disease
• Heart attacks
• Cardiomyopathy, which means that your heart gets stiff after many years of high blood pressure

Other problems that may cause fluid to build up in the lungs include:

• Blood transfusion reaction (certain proteins in donor blood may damage the lungs)
• Severe injury to the lungs, such as from inhaling chemicals or a large amount of smoke from a fire
• Infections such as pneumonia
• Kidney failure
• Some medicines
• Traveling to a high altitude

What are the symptoms?

Symptoms may include:

• Trouble breathing when you lie down
• Coughing up blood or frothy spit
• Feeling restless or anxious
• Heavy sweating
• Shortness of breath that may be severe
• Swelling of the legs and ankles

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• Heart catheterization, which uses a small tube called a catheter inserted into a blood vessel, contrast dye, and X-rays to measure blood flow and see how well the heart is pumping
• Blood tests
• Chest X-ray
• CT scan, which uses X-rays and a computer to show detailed pictures of the chest
• An ECG (also called an EKG or electrocardiogram), which measures and records your heartbeat
• Lung scan which uses a small amount of radioactive material injected into your blood or inhaled to make detailed pictures of your lungs
• An echocardiogram, which uses sound waves (ultrasound) to see how well your heart is pumping

How it treated?

You will be given oxygen to help you breathe. Depending on the cause, you may be given medicine to:

• Relax your blood vessels
• Lower blood pressure in your lungs
• Help your heart pump
• Get rid of extra water in your body
• Lessen anxiety and stress

Your healthcare provider may recommend that you follow a low-salt diet and take a diuretic (water pill) regularly. Too much salt can cause your body keep too much water.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Carefully follow your provider's instructions for taking medicines.
• Do not smoke.
• Follow your provider's recommendations for physical activity. Exercise helps strengthen your heart and body and improves your blood flow and energy level. Avoid outdoor exercise if it is very hot, cold or humid. Getting very hot or cold may cause your heart to work harder. Balance exercise with rest.
• Follow your healthcare provider's advice on how much liquid you should drink.
• Follow a low-sodium diet if recommended by your healthcare provider. Be careful about adding salt substitutes to your food. Many contain high levels of potassium. Salt substitutes may raise the potassium levels too much.
• Weigh yourself and write down your weight every day. Weigh yourself in the morning after you use the bathroom but before eating breakfast. Tell your healthcare provider if you gain 3 or more pounds in 1 day or 5 or more pounds in 1 week, or if you keep gaining weight over weeks to months. Weight gain may mean your body is having trouble getting rid of extra fluid.
• Try not to get sick with a cold or the flu, which can be very serious if you have pulmonary edema. Stay away from people who are sick and get a flu shot every year. Ask your healthcare provider if you need a pneumococcal shot.

Ask your provider:

• How and when you will get your test results
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.