​Amazing Facts About Pulmonary Edema

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Do you remember to appreciate that you can breathe easily, especially when you are lying down without any interference? What might seem usual is not the same for anyone with pulmonary edema.

Struggling to get enough air and frequently becoming short of breath, mostly during an activity, is an unpleasant experience. It even gets worse when you can't breathe well while lying down.

Lack of enough oxygen into your lungs would affect not only your lungs but also other vital body systems. Every cell in your body system requires adequate oxygen to operate efficiently as it should. (Read more body systems here)

What Is Pulmonary Edema?

Pulmonary edema, or pulmonary congestion, is a condition with fluid accumulation in the lungs. Excess fluid fills up most of the lung's alveoli (air spaces and tissue), leaving very little space for gas exchange.

"Pulmonary" is a medical word that means "lungs," while "edema" is a Greek word which means "swelling." Pulmonary edema, therefore, means 'lung swelling.' Fluid collection in the lungs can lead to respiratory failure.

Acute Pulmonary Edema or Chronic Pulmonary Edema

Pulmonary edema can occur suddenly, which is acute pulmonary edema, or it can be chronic when it happens slowly and over time.

Acute Pulmonary Edema (APE)

Acute pulmonary edema is a significant health concern that requires medical emergency management. It has a high mortality rate compared to chronic pulmonary edema, primarily when associated with coronary artery disease.

The primary feature of acute pulmonary edema is the way it develops suddenly within a short time with a rapid onset of signs and symptoms. Pulmonary congestion and severe respiratory distress are some signs of acute pulmonary edema.

Chronic Pulmonary Edema (CPE)

Chronic pulmonary edema is a long-term type that happens over time, unlike the acute type that occurs suddenly. 

How Does Pulmonary Edema Occur?

The tiny air sacs of the lungs, also known as alveoli, are the central area where the gas exchange occurs. The lungs oxygen passes through the air sacs and into the tiny blood vessels for onwards to the circulatory system.

Likewise, the alveoli receive waste gas from the body for expiration.

When a problem with the heart's left ventricle occurs due to some heart issues such as heart failure, arrhythmia, or blood pressure, your heart fails to serve the lungs efficiently.

The left atrium and the left ventricle are responsible for pumping oxygenated blood from the lungs for onward circulation to the body.

Due to some health conditions, this part of the heart can fail to sufficiently pump blood out of the lungs, leading to blood back up in the air sacs' tiny blood vessels. The fluid overload of the small capillaries would cause them to leak fluid into the air sacs leading to fluid buildup or pulmonary edema.

Excess fluid in the air sacs interferes with gas exchange, causing symptoms such as coughing and breathing difficulties. 

Some causes of Pulmonary Edema include spinal cord injury, near drowning and exposure to toxic smoke.

Causes of Pulmonary Edema

Pulmonary edema is classified as cardiogenic and non-cardiogenic. Each of these two types has its distinct etiology or causing factors.

Cardiogenic Pulmonary Edema

The primary cause of cardiogenic pulmonary edema is heart disease. Therefore, as the name suggests, cardiogenic pulmonary edema relates to the heart. It is a type typically caused by congestive heart failure that affects the left side of the heart.

The heart's left ventricle fails to function efficiently due to either systolic or diastolic dysfunctions. The weak heart creates blood volume overload in the left ventricle, which leads to high fluid pressure in the capillaries and causing them to leak into the alveoli.

Non-Cardiogenic Pulmonary Edema

Non-cardiogenic means 'not related to the heart.' Other conditions besides heart problems, can cause pulmonary edema. Causes of non-cardiogenic pulmonary edema include:

Pulmonary embolism: Pulmonary embolism is a medical term meaning blood clots in the lungs. How does pulmonary embolism cause pulmonary edema? When a deep vein of your legs has a blood clot, it travels to the lungs blocking the normal blood flow and fluid buildup or pulmonary edema.

Acute respiratory distress syndrome (ARDS): Lungs infections, injury, trauma, toxins, and sepsis can cause ARDS. The respiratory response to ARDS infection and inflammation can cause leaky capillaries in the alveoli leading to pulmonary edema.

Central nervous system insult: Spinal cord injury, traumatic brain injury, meningitis, and head injury are some of the nervous system conditions that could lead to pulmonary edema. Neurogenic pulmonary edema is an acute and severe type of pulmonary edema.

Kidney failure: A dysfunctioning kidney can cause fluid and pressure increase in the blood vessels, leading to pulmonary edema.

Near drowning: Near underwater suffocation means inhaling water into the lungs. It leads to acute pulmonary edema. Near drowning is a life-threatening occurrence that would require immediate medical attention.

Early treatment can not only reverse the pulmonary edema but also prevent other severe complications.

Drug overdose or drug reaction: Overdose of simple drugs such as aspirin or overuse of illicit drugs like heroin or cocaine may lead to pulmonary edema due to the drug reaction.

Inhaling toxins and smokes: Inhaling toxins, chemical fumes, smoke, cocaine or heroin, and aspiration are some of the toxic exposures that could cause fluid buildup in the air sacs.

High-altitude: Sudden ascending to high-altitude areas of about 10,000 feet without prior exposure to such altitude or height can cause High-altitude pulmonary edema (HAPE).

Viral infection: Some particular viruses can cause pulmonary edema, such as dengue.

Pneumonia: One of the significant characteristics of pneumonia is fluid buildup in the alveoli, leading to pulmonary edema.

You can easily confuse pulmonary edema with other health conditions such as pneumonia, pleural effusion, and ARDS. Therefore, it is essential to compare the two conditions against pulmonary edema to quickly identify and tell them apart.

Pulmonary Edema vs Pneumonia

Pneumonia is a lung disease that has three similarities with pulmonary edema. It is a life-threatening disease and also causes excess fluid in the alveoli (air sacs). Both pulmonary edema and pneumonia are restrictive diseases that decrease lung compliance.

However, the cause of the two lung conditions varies widely. Pneumonia can either be caused by a virus, bacteria, or fungi. It can also be a progressive infection from a common cold or flu in the case of a weak or compromised immune system.

On the other hand, pulmonary edema is typically cardiac-related, which means it is primarily caused by heart disease, although it accounts for other causes. Pneumonia can also lead to pulmonary edema, one of the causes of non-cardiogenic pulmonary edema.

Some of the pneumonia symptoms are:

  • Coughing (productive)
  • Shortness of breath
  • Fever
  • Chest pain
  • Fatigue

Pulmonary Edema vs Pleural Effusion

Pleural effusion is another lung condition that causes fluid buildup. However, there is a clear contrast between pulmonary edema and pleural effusion.

With pleural effusion, the fluid collects in the pleural cavity outside the lungs, while pulmonary edema has fluid buildup in the alveoli within the lungs.

Some similarities between these two conditions besides fluid buildup are some of the causing factors and some symptoms. Pleural effusion can be caused by congestive heart failure and pneumonia, causing pulmonary edema factors.

Some symptoms of the pleural effusion are:

  • Dry (non-productive) cough
  • Difficulty breathing or taking deep breaths
  • Dyspnea (shortness of breath)
  • Fever
  • Chest pain
  • Orthopnea (inability to breathe when lying down)

If you have any of the said symptoms, visit your doctor immediately for diagnoses and treatment. With a few processes, your doctor can ascertain the condition and the damage extent to your lungs. 

Pulmonary Edema symptoms include night coughing, shortness of breath and swelling of the legs and feet.

Pulmonary Edema Symptoms

Symptoms of pulmonary edema can vary due to the way it occurs. For instance, pulmonary edema can occur suddenly (acute) or over time (chronic). Both types of pulmonary edema have some varying symptoms that help to recognize and diagnose them quickly.

Acute Pulmonary Edema Symptoms. The following are some of the acute pulmonary edema symptoms:
  • Coughing up frothy sputum that might have traces of blood
  • Sudden dyspnea or shortness of breath, especially when lying down
  • Palpitations (strong, rapid, or uneven heartbeat)
  • Bubbly, gasping or wheezing sounds when breathing
  • Cold and clammy bluish skin
  • Feeling weak, apprehensive, lightheaded, or sweaty probably from low blood pressure
  • Feeling of suffocation or drowning and hungering for air. It is an unpleasant experience medically called paroxysmal nocturnal dyspnea. It happens when lying down or sleeping, and you wake up struggling to breath

Symptoms of Chronic Pulmonary Edema. The following are some of the chronic pulmonary edema symptoms:
  • Dyspnea (difficulty breathing) when lying down or during an activity
  • Night coughing and difficulty breathing that can resolve when you sit up
  • Swollen feet and legs
  • Unexplained rapid weight increase
  • Fatigued without a reason
  • Wheezing

Symptoms of High-Altitude Pulmonary Edema (HAPE). Some of the high-altitude pulmonary edema symptoms are:
  • Headache
  • Chest pain or discomfort
  • Dry cough that later changes to productive with frothy sputum and traces of blood
  • Difficulty breathing or shortness of breath mostly during an activity
  • Fast and irregular heartbeat
  • Weakness

Pulmonary Edema Risk Factors. Heart conditions that could cause heart failure are the top risk factors of pulmonary edema.

Others are:

  • Family history of pulmonary edema
  • Exposure to inhaled toxins
  • Smoking
  • Aspiration
  • Overweight
  • Diabetes
  • Pneumonia
  • Sepsis
  • Blood clot
  • High altitude
  • Heart defect and pulmonary hypertension in children

Pulmonary Edema Diagnosis

A proper diagnosis of pulmonary edema is a prelude to the right treatment. Your doctor may need to perform various procedures to find out more about your condition.

Your doctor can perform the initial diagnosis, such as physical examination, while asking questions such as how you feel. If in doubt of the findings, an X-ray can be the next diagnosis procedure to clarify the doubts.

Those few procedures are enough to provide results and start treatment immediately. It is necessary to directly get on the treatment, especially if it is the life-threatening type, acute pulmonary edema.

The following are more of the diagnosis processes you might have to go through according to your doctor's decisions.

Medical History

Medical history is the information you give to your doctor concerning your pulmonary edema. Your doctor may ask to know whether you have an underlying disease and how long you have had it.

Telling your doctor how you are feeling is essential for guidance to the next level of diagnosis. Explaining your symptoms to the latter, even what you think is not fundamental, is the epitome of the whole diagnosis process and treatment.

Physical Examination

Listening to your lungs using a stethoscope for any bubbly, crackling, or wheezing pulmonary edema sounds. Still using the stethoscope, your doctor may listen to your chest to check for rapid breathing and irregular heart rhythms.

Your doctor may continue to examine whether your skin color is turning blue or whether you have a swollen stomach, legs, and a prominent neck vein. All these are indications of excess fluid in the body.

Chest X-Ray

A chest X-ray can reveal signs of pulmonary edema which would show darker areas of the lungs. A fluid-filled lung displays whitish images on the affected areas.

Chest CT Scan (Computed Tomography Scan)

A CT scan is a computed procedure that reveals real images for further clarification of the disease's existence and its extent, and whether it is cardiogenic. The scan procedure captures images of the lungs and the heart.

Lungs Ultrasound

It is an exact procedure that reveals pulmonary edema and the status of the pleural cavity. The sound-waves process can also check the amount of blood flow in the lungs.

Blood Test

Your doctor might require some blood tests to confirm the presence of pulmonary edema and whether it is cardiogenic or non-cardiogenic. Two of the blood tests are:

Arterial blood gas test: Arterial blood gas test (ABG test) analyzes the amount of oxygen and carbon dioxide in the blood.

B-type natriuretic peptide blood test (BNP): BNP is a blood test to check and confirm heart problems such as heart failure.

Echocardiogram

It is a heart test using sound waves that checks the heart's condition and how it functions, whether there is any abnormality that can cause pulmonary edema. 

Your doctor may perform a chest x-ray, echocardiogram or a chest CT scan to diagnose Pulmonary Edema.

Pulmonary Edema Treatment

Treatment for pulmonary edema may differ with each case due to inconsistent findings from the diagnosis. The heart rhythm, systolic blood pressure, and urine output would guide a doctor on the right treatment method.

While treatment is ongoing, your doctor may continue to closely monitor such conditions up to when stabilization is realized.

The base of treating pulmonary edema is to reduce capillary pressure in the alveoli, redistribute the excess fluid to the rest of the body, and improve the fluid flow.

Oxygen Supplementation and Mechanical Ventilation: Pulmonary edema causes low oxygen in the blood due to dysfunctional alveoli. Oxygen supplementation and mechanical ventilation are the emergency procedures you require immediately you get to the hospital.

You may use a face mask or nasal plastic tubes according to your doctor for oxygen supplementation.

Once your oxygen intake begins to improve and the level stabilizes, other necessary treatments may follow.

Diuretics: Treatment to decrease pressure in your heart and lungs caused by pulmonary edema would be the next immediate treatment. Your doctor may start you on oral furosemide (Lasix) or preferably intravenous for quick results.

Furosemide is a therapy for reducing excess fluid in the lungs and consequently treating body swelling and shortness of breath.

Vasodilators: Nitroglycerin is one of the vasodilators your doctor may use to improve your cardiac output or performance.

Morphine: The medical narcotic may have several uses in the treatment of pulmonary edema. It can help relieve shortness of breath and reduce pulmonary edema by improving venous dilation. Also, your doctor may administer it as an anxiolytic to reduce anxiety.

Your doctor can administer morphine either orally or intravenously. However, a critical appraisal of morphine reports that morphine therapy may have adverse effects outweighing the benefits. If your doctor must use morphine, they must observe caution to avoid causing respiratory depression.

Diet: Your doctor may authorize a low-salt diet to lower fluid retention and continue monitoring the lungs' amount of fluid.

Thoracentesis: Thoracentesis is a procedure of removing fluid from your lungs. A needle is inserted through the chest walls to the lungs to draw out the excess fluid.

Other treatments: Since pulmonary edema results from other health conditions, it would be prudent to treat the underlying disease. Your situation might improve when you sort out the disease-causing it.

These other treatments may include antihypertensive drugs for hypertension treatment. If it is a case of severe heart failure, beta-blocker, ACE inhibitor, and mineralocorticoid receptor antagonist might be the choicest treatment.

It is essential to get the right timely treatment for pulmonary edema to avoid more complications and chances of fatality.

Your doctor may prescribe oxygen supplementation, diuretics or morphine as treatment for Pulmonary Edema.

Pulmonary Edema Complementary and Alternative Treatment

Besides getting the right conventional treatment, you can use complementary and alternative therapies to strengthen your lungs and heart. Like traditional treatment, you need the right direction, guidance, and prescription from a natural therapist.

Before you think about using pulmonary edema natural remedies, it would be best to discuss it with your doctor or your natural health therapist. Some of the natural therapies can react with some of your current standard treatment.

The following are some of the complementary and alternative therapies for pulmonary edema:

Herbs

Herbs therapy date back many centuries ago as traditional medicine for various diseases. Herbs are useful not only for disease treatments but for supporting the immunity system and toning body systems.

The following are some herbs for the treatment of cardiogenic pulmonary edema:

  • Hawthorn (Crataegus monogyna)
  • Ginkgo (Ginkgo biloba)
  • Forskolin (Coleus forskohlii)
  • Astragalus (Astragalus membranaceus)
  • Some herbs for the treatment of non-cardiogenic pulmonary edema:
  • Garlic (Allium sativum)
  • Horsetail (Equisetum arvense)
  • Rosemary (Rosmarinus officinalis)

Vitamins and Supplements
  • Magnesium
  • Potassium
  • Vitamin C and E
  • Vitamin B1 (Thiamine)
  • CoQ10 (Coenzyme Q10)

Other Alternative TherapiesLifestyle Changes and Home Remedies for Pulmonary Edema
Lifestyle changes are useful for supporting your lung and heart health. For instance:
  • Quit smoking
  • Regulate your alcohol use
  • Exercise regularly
  • Eat a well-balanced diet

Home Remedies

  • Sleeping position
  • Elevate your head with pillows and, lying down with your back straight, place a pillow between your legs. Or, if you prefer lying on your back, elevate your head with pillows, bend your knees and support them using a pillow.

Conclusion

Pulmonary edema is a severe and life-threatening disease. Your quick and full recovery will entirely depend on how soon you begin your therapy.

Even though acute pulmonary edema has a high fatality chance, it is treatable and curable if you get your treatment early enough without delay.

Would you like to discuss anything concerning your health with a health expert? Talk to our Natural Health Practitioner and Master Herbalist, Yvonne, who will answer all your questions.

We can help bring our clinic closer to you through an 'on-phone' consultation to help you return to perfect health. You can call us on 1-250-468-7685 for the consultation.

Try out our absolutely FREE virtual health consultation with Yvonne by filling out an online form to provide us with more details about your health. We will then contact you to schedule the talk.

You can also write your questions, thoughts, or insights to share with us and others in the comments box below. Please share this information with others through your social media to help educate them on health matters. 


Yvonne Dollard Perc: Owner of Island Healthworks, Natural Health Practitioner, Teacher, Writer and Editor.
Elizabeth Njuguna: Researcher, Freelance Writer, with a Focus on Natural Health.
Sherry Robb: Print, Web and Social Media Designer Specializing in the Natural Health and Fitness Industries.

Island Healthworks offers in-person and virtual consultations for assessment of your specific needs, with health & lifestyle coaching, featuring the best of integrative natural health care. To book your consultation, please call 250-468-7685!

This article is intended for educational purposes and the information contained within is not intended to treat, diagnose or cure any disease or health problem. Please seek appropriate medical attention for any health complaints. We cannot take responsibility for your health care decisions. Our intent is only to offer health information to help you with your search for better health. 

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Saturday, 08 May 2021