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Pulmonary Edema

What is pulmonary edema?

Pulmonary edema is a buildup of fluid in the alveoli (air sacs) of your lungs. This may make it hard for you to breathe. Pulmonary edema may be life-threatening if your body is not able to get the oxygen it needs.

What causes pulmonary edema?

  • Heart conditions, such as an abnormal heartbeat, damaged heart valve, high blood pressure, heart attack, or heart failure

  • Lung infection, injury, or a blocked airway

  • Thoracentesis (a procedure to remove fluid from around your lung)

  • Travelling to high altitudes, such as in the mountains, leading to high altitude pulmonary edema (HAPE)

  • A reaction to a blood transfusion

  • Certain medicines, such as those used to treat inflammation, and illegal drugs

What are the signs and symptoms of pulmonary edema?

  • Wheezing, trouble breathing, or faster breathing than usual

  • Chest discomfort or heaviness

  • Coughing up pink, foamy sputum (spit)

  • Fatigue or feeling the need to rest often

  • Pale or blue nail beds and lips

  • Fast heart rate or sweating for no known reason

  • Feeling anxious

How is pulmonary edema diagnosed?

Your caregiver will ask about your signs and symptoms. He will examine you, listen to your heart and lungs, and check your blood pressure. He will ask if you have any health conditions and which medicines you take. You may also need the following tests:

  • Blood tests: A sample of your blood may be sent to the lab for tests. These may help find the cause of your symptoms. They may also be used to make sure organs, such as your kidneys, are working correctly.

  • Blood gases: This is also called an arterial blood gas, or ABG. Blood is taken from an artery (blood vessel) in your wrist, arm, or groin. Your blood is tested for the amount of oxygen and carbon dioxide in it. The results can tell caregivers how well your lungs are working.

  • Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to look for signs of a lung infection or other damage.

  • EKG: This test records the electrical activity of your heart. It is used to see if a heart condition is the cause of your pulmonary edema.

  • Echocardiogram: This is a type of ultrasound done to show the size and shape of your heart. Caregivers may check for problems with your heart valves and signs of heart failure. This may be done to find the cause of your pulmonary edema.

How is pulmonary edema treated?

Treatment will depend on what caused your pulmonary edema. If high altitude caused your pulmonary edema, your symptoms may go away when you go to a lower altitude. You may also need any of the following:

  • Medicines:

    • Diuretics: This medicine is given to remove excess fluid from around your lungs and decrease your blood pressure. You may urinate more often when you take this medicine.

    • Heart medicine: These medicines may be given to make your heartbeat stronger or more regular, or to lower your blood pressure.

    • Vasodilators: Vasodilators may improve blood flow by making the blood vessels in your heart and lungs wider. This may decrease the pressure in your blood vessels and improve your symptoms.

  • Breathing support:

    • Oxygen: This may help you breathe better and decrease the pressure in your lungs. You may get oxygen through a plastic mask or nasal cannula. A nasal cannula is a pair of short, thin tubes that are placed inside your nostrils.

    • Noninvasive positive-pressure ventilation (NPPV): This is a machine that helps your lungs fill with air through a mask or a mouthpiece, and helps you breathe better. If a mask is used, it may go over your nose and mouth, or just your nose. Extra oxygen may also be given to you through the machine.

    • Ventilator: This is a machine that can breathe for you if you cannot breathe well on your own. You may have an endotracheal (ET) tube in your mouth or nose. The ET tube is hooked to the ventilator. The ventilator can also give oxygen to you.

What are the risks of pulmonary edema?

  • The levels of potassium in your blood may change and lead to abnormal heartbeats. Your heart may beat too quickly or too slowly. If you need an ET tube and ventilator to breathe, your throat may be injured when the ET tube is put in. You may also get a lung or sinus infection, and your heartbeat may become irregular.

  • Without treatment, your symptoms may get worse. You may become very tired from a lack of oxygen. You could go into a coma. A coma is when you are not conscious, and cannot be woken. Your heart may not pump as it should, and your body may not get the oxygen it needs to function. If left untreated, pulmonary edema may be life-threatening.

How can I manage or prevent pulmonary edema?

  • Limit your liquids as directed: Follow your caregiver's directions about how much liquid you should drink each day. Too much liquid can increase your risk for fluid buildup.

  • Weigh yourself daily: Weigh yourself at the same time every morning after you urinate, but before you eat. Weight gain can be a sign of extra fluid in your body.

  • Rest as needed: Return to activities slowly, and do more each day. You may have trouble breathing when you are lying down. Use foam wedges or elevate the head of your bed. This may help you breathe easier while you are resting or sleeping. Use a device that will tilt your whole body, or bend your body at the waist. The device should not bend your body at the upper back or neck.

  • Eat a variety of healthy foods: Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Healthy foods may decrease your symptoms and help you have more energy. Ask if you need to eat low-salt or low-fat foods.

  • Limit or avoid alcohol: You will need to limit the alcohol you drink, or avoid alcohol completely. Alcohol can worsen your symptoms and increase your blood pressure. If you have heart failure, alcohol can make it worse.

  • Do not smoke or take drugs: If you smoke, it is never too late to quit. Do not take street drugs, such as cocaine. Smoking and drugs can make your condition and symptoms worse. Ask for information if you need help quitting.

  • Climb to high altitudes slowly: Go slowly to allow your body to get used to a higher altitude. Ask your caregiver about the symptoms of high altitude pulmonary edema (HAPE). Ask what to do if you get these symptoms.

When should I contact my caregiver?

Contact your caregiver if:

  • You have a fever.

  • You gain weight for no known reason.

  • You urinate more than usual.

  • You have new or increased swelling in your legs or feet.

  • You hear new or increased wheezing when you breathe.

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You are breathing very fast, sweating, and feel confused.

  • You have chest pain or trouble breathing that gets worse.

  • Your heart feels like it skips a beat or flutters.

  • You urinate very little or not at all.

  • You cough up pink, foamy sputum.

  • Your lips and nail beds are pale or blue.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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