Pulmonary edema is a condition characterized by symptoms of difficulty breathing due to a buildup of fluid in the lung sacs (alveoli).Epulmonary fever divided to acute pulmonary edema, chronic pulmonary edema, and hhigh-altitude pulmonary edema (HAPE).
Pulmonary edema is more common in the elderly. This condition is experienced by 1 in 15 people aged 75–84 years, and 1 in 7 people aged 85 years and over with heart failure conditions.
Types of Pulmonary EdemaCauses of Pulmonary Edema
Causes of pulmonary edema are categorized into 2 groups, namely pulmonary edema associated with heart problems (cardiogenic pulmonary edema) and pulmonary edema that occurs without heart problems (noncardiogenic pulmonary edema).
Normally, the heart pumps blood throughout the body from a part of the heart called the left ventricle. The blood pumped from the left ventricle is blood from the lungs which contains oxygen.
Pulmonary edema caused by heart problems generally occurs because the left ventricle is not able to pump blood out of the heart optimally. As a result, blood remains in the left ventricle and causes an increase in pressure.
Increased pressure in the left ventricle will make it more difficult for blood from the lungs to enter the heart, so the blood will be blocked in the pulmonary veins. If the pressure in the pulmonary veins is too high, some of the fluid from the blood vessels will be pushed out and into the alveoli.
The following are some disorders of the heart that can cause pulmonary edema:
- Coronary heart disease
- Hypertension
- Cardiomyopathy
- heart valve disease
Meanwhile, non-cardiogenic pulmonary edema can be caused by a variety of conditions, including:
- Acute respiratory distress syndrome
- Viral infections, including COVID-19
- Pulmonary embolism
- Injury to the lungs
- Sink
- Located at altitude (above 2,400 meters above sea level)
- Head injury or seizure
- Complications of brain surgery
- Inhaling smoke during a fire
- Exposure to toxins, such as ammonia and chlorine
- Reactions to some medications, including aspirin
Pulmonary Edema Risk Factors
Several factors that can increase a person's risk of developing pulmonary edema are:
- Have heart problems or heart failure
- Have you had pulmonary edema before?
- Have a lung disease, such as tuberculosis or chronic obstructive pulmonary disease (COPD)
- Have blood vessel disorders
Symptoms of Pulmonary Edema
A common symptom experienced by suffering from pulmonary edema is difficulty breathing. However, other symptoms that arise can be slightly different for each person, depending on the type of pulmonary edema suffered.
In acute edema, symptoms that can occur include:
- Sudden shortness of breath, especially after activity or when lying down
- Feeling like drowning or heart palpitations
- Nervous
- Difficulty breathing with profuse sweating
- Making unusual breath sounds, such as rough, wheezing, or gasping breaths
- Coughing up frothy phlegm mixed with blood
- Skin that is cold and clammy or looks pale or bluish
- Fast and irregular heartbeat (palpitations)
- Feeling dizzy, weak, or sweaty
While in chronic pulmonary edema, symptoms that may be experienced include:
- Get tired more easily
- Weight gain fast
- Breathing becomes heavier than usual, especially when moving and lying down
- Swelling in both legs
- Wheezing
- Often wakes up at night because of shortness of breath
Highland pulmonary edema or hhigh-altitude pulmonary edema (HAPE) can occur when sufferers travel or exercise at very high altitudes. Signs and symptoms that may appear include:
- Headache
- Shortness of breath after activity, which continues to shortness of breath at rest
- Dry cough, which progresses to coughing up frothy phlegm mixed with blood
- Difficulty walking uphill, which progresses to difficulty walking on flat surfaces
- Fever
- Weak
- Chest pain
- Fast heartbeat
When to go to the doctor
Immediately see a doctor or emergency room if you experience symptoms of acute pulmonary edema, pulmonary edema HAPE, or chronic pulmonary edema as mentioned above.
Don't drive yourself to the hospital. It's best to call an ambulance or a medical officer for help.
If you see someone having an attack of acute pulmonary edema, take them to a hospital immediately or call an ambulance. Tell the doctor the symptoms the patient is experiencing so that the doctor can provide appropriate help.
Routine examinations may be recommended if you are at high risk of developing pulmonary edema, to prevent serious conditions.
Pulmonary Edema Diagnosis
To diagnose pulmonary edema, the doctor will ask questions about the symptoms experienced and the patient's medical history, especially if the patient has had heart or lung disease.
Next, the doctor will perform a physical examination by checking the heartbeat and sounds from the lungs using a stethoscope. If needed, the doctor can also perform a number of additional examinations, such as:
- pulse oximetry, to quickly measure the level of oxygen in the blood, by placing the sensor on the fingers or toes
- Electrocardiogram (ECG), to look for problems with heart rhythm, an overview of the function of the heart muscle, and the possibility of coronary heart disease
- Chest X-ray, to confirm that the patient really has pulmonary edema, as well as to see other possible causes of shortness of breath
- Blood tests, to measure the levels of oxygen and carbon dioxide in the blood (blood gas analysis), measure hormone levels B-type natriureticcpeptide (BNP) which is elevated in heart failure, and see thyroid and kidney function
- Echocardiography, to determine if there is a problem with the pumping function of the heart
- Cardiac catheterization, used to measure pressure in the heart chambers, evaluate the work of heart valves, and check the smooth flow of blood in the coronary arteries of the heart
Pulmonary Edema Treatment
As the first treatment for pulmonary edema, the patient will be given oxygen. Oxygen is given through a face mask or a small tube that is placed in the nose.
Based on the condition and cause of pulmonary edema, the doctor may also prescribe one or more of the following medicines:
- Diuretics, such as furosemide, to lower pressure caused by excess fluid in the heart and lungs
- Blood pressure medication, to control high blood pressure or raise blood pressure that is too low
- Nitrate drugs, such as nitroglycerin, to dilate blood vessels and reduce the pressure load on the left ventricle of the heart
Most conditions of pulmonary edema require treatment in the emergency room or intensive care unit (ICU). If necessary, the patient will be placed on a tube that is connected to a breathing apparatus to ensure that enough oxygen enters the body.
Complications of Pulmonary Edema
Untreated pulmonary edema can cause increased pressure in the right heart chamber, which is responsible for receiving blood from the rest of the body. This condition can cause the right heart chamber to fail and cause:
- Accumulation of fluid in the abdominal cavity (ascites)
- Swelling in the legs
- Swelling of the liver
Prevention of Pulmonary Edema
The risk of developing pulmonary edema can be reduced by taking the following simple steps:
- Do exercise regularly, 30 minutes every day.
- Consume healthy foods in the form of vegetables, fruits, and foods low in fat, sugar, and salt. It aims to keep body weight, blood cholesterol levels, and blood pressure within limits
- Do not smoke.
- Manage stress well.