Introduction

Pulmonary edema is a serious medical condition in which excess fluid builds up in the lungs, particularly in the tiny air sacs (alveoli). This prevents normal oxygen exchange and causes difficulty in breathing. It can occur suddenly (acute) or develop gradually (chronic). Without timely treatment, pulmonary edema can be life-threatening.

Symptoms

The signs and symptoms can vary depending on the cause and severity, but common ones include:

• Shortness of breath (especially when lying down)
• Rapid, shallow breathing
• Cough producing frothy sputum (sometimes pink or blood-tinged)
• Chest pain or tightness
• Wheezing
• Swelling in legs or feet (if heart-related)
• Bluish lips or fingers (cyanosis)
• Fatigue or weakness
• Anxiety, restlessness, or a feeling of drowning

Causes

Pulmonary edema can be divided into two main categories:

1. Cardiogenic Pulmonary Edema (heart-related):

• Heart failure (left ventricular dysfunction)
• Heart attack (myocardial infarction)
• Hypertension (high blood pressure)
• Heart valve disease

2. Non-Cardiogenic Pulmonary Edema (non-heart-related):

• Pneumonia or severe lung infection
• Kidney failure (fluid overload)
• Inhalation of toxic gases, smoke, or chemicals
• High-altitude pulmonary edema (HAPE)
• Sepsis (severe infection in the body)
• Drug overdose or reaction to medications

Diagnosis

Doctors diagnose pulmonary edema using:

• Physical examination: Listening to abnormal breath sounds (crackles/wheezing)
• Chest X-ray: Shows fluid in lungs
• Blood tests: Check oxygen levels and kidney/heart function
• Echocardiogram (ECHO): Evaluates heart performance
• Electrocardiogram (ECG): Detects heart rhythm problems
• Arterial Blood Gas (ABG): Measures oxygen and carbon dioxide in the blood

Treatment

The goal of treatment is to improve oxygen supply and reduce fluid buildup:

1. Oxygen therapy: Mask or ventilator to increase oxygen levels
2. Medications:
   • Diuretics (e.g., Furosemide) – remove excess fluid
   • Vasodilators (e.g., Nitroglycerin) – reduce blood pressure and ease heart workload
   • Inotropes – strengthen heart pumping if needed
   • Antibiotics – if caused by infection
3. Treating underlying cause:
   • Heart disease management
   • Kidney disease treatment
   • Removing or avoiding toxic exposure
4. Emergency care: ICU support in severe or sudden cases

Prevention

• Control blood pressure, diabetes, and heart disease
• Take heart medications regularly as prescribed
• Reduce salt intake to avoid fluid retention
• Avoid smoking and alcohol
• Exercise regularly and maintain a healthy weight
• Use precautions when traveling to high altitudes
• Get timely treatment for infections and chronic conditions