Introduction

Pulmonary edema happens when fluid collects in the lungs, where it should not. This extra fluid can cause breathing problems, coughing that brings up foam or mucus, a whistling sound while breathing, a heavy feeling in the chest, and trouble catching your breath. Pulmonary edema can be dangerous and needs quick treatment from doctors.

Causes

There are two main types of causes for pulmonary edema:

Cardiogenic reason Cardiogenic pulmonary edema happens when heart issues cause fluid to build up in the lungs. Congestive heart failure is the main reason behind this condition. If the left side of the heart cannot pump blood, blood backs up in the lung's blood vessels. Rising pressure in these vessels forces fluid into the lung's air sacs. Pulmonary edema from congestive heart failure can result from:

• A heart attack
• Weak heart muscles (cardiomyopathy)
• Heart valves that do not close or are too tight (valvular heart disease)
• High blood pressure or hypertension
• Irregular heartbeat (arrhythmia)
• Swelling or inflammation in the heart muscle (myocarditis)
• Fluid build-up in the sac surrounding your heart (pericardial effusion)

Noncardiogenic reason Other illnesses can cause noncardiogenic pulmonary edema, which makes fluid collect in your lungs. This doesn't happen because of increased lung blood flow linked to heart issues. Instead, your lung blood vessels get damaged or inflamed. Once that happens, the vessels start leaking, and the fluid ends up in your air sacs. People also call noncardiogenic pulmonary edema adult respiratory distress syndrome, or ARDS. The main issue with ARDS is inflammation. Several things can trigger it, like:

• Pneumonia
• Serious infections (sepsis)
• Injuries or trauma
• Issues with the pancreas (pancreatitis)
• Problems with the liver
• Drug use
• Brain bleeding or swelling also known as neurogenic pulmonary edema

Negative pressure pulmonary edema

• Negative pressure pulmonary edema happens when your upper airway gets blocked. Trying hard to breathe during this kind of blockage harms your pulmonary blood vessels causing them to leak into your air sacs. In cases of high altitude pulmonary edema, the blood vessels in your lungs tighten and begin to leak as well.
• Sudden pulmonary edema
• People with sudden pulmonary edema may notice signs such as:
• Breathing troubles when active or lying flat.
• Coughing up pink, frothy mucus or blood.
• Wheezing.
• Struggling to catch their breath.
• A drowning or suffocating sensation.
• Chest pain or discomfort.
• Chronic pulmonary edema
• The signs of long-term pulmonary edema often overlap with those of sudden pulmonary edema, but they may not be as severe. Additional symptoms of long-term pulmonary edema include:
• Waking up feeling out of breath.
• Trouble breathing while lying flat.
• Swollen legs.
• Feeling very tired.

Diagnosis

To check if fluid is in your lungs, a doctor will do a physical exam. They use a stethoscope to listen to your heart and lungs. During the exam, they look for specific signs in the body like:

• Heart rate or blood pressure that goes up or down.
• Faster breathing.
• Irregular heartbeats.
• Wheezing, whistling, or crackling sounds in your lungs.
• Swelling in your body.
• Skin that looks grey or bluish.
• Doctors may order more tests if they believe there is fluid in your lungs.
• Complete blood count or CBC
• Blood chemistry tests
• Pulse oximetry to check oxygen levels in your blood
• Chest X-ray to see if fluid is present in your lungs
• Echocardiogram, which uses ultrasound to look at unusual heart activity
• Electrocardiogram or EKG to detect heart rhythm issues or heart attacks
• Cardiac catheterisation to find blockages in coronary arteries

Treatment

Pulmonary edema is a life-threatening condition. If it happens, it requires fast treatment. Patients may need care in an ER or ICU. Some of the ways to treat it include:

• Tubes in your nose supply oxygen to help you breathe more.
• Machines pump air into your lungs through a face mask to support breathing.
• Ventilators push air into your windpipe using a tube placed there.
• Drugs can make you urinate to reduce fluid or help your heart work better.
• If fluid build-up isn’t due to congestive heart failure, doctors might use antibiotics or steroids.

How to Prevent It?

If you have a higher chance of getting pulmonary edema, you can take actions to care for your health. These actions include:

• Follow your prescription if you have a heart problem.
• Keep up with your regular vaccines.
• Visit your doctor often and reach out if you struggle to breathe.
• Choose meals that are nutritious and have little salt.
• Avoid smoking.
• Work on staying at a weight that’s good for your health.
• Discuss with your doctor before doing activities like mountain climbing, which might lead to pulmonary edema.