Pulmonary edema is a special form of edema. I understand edema to mean a pathological accumulation of water in the tissue. In the case of pulmonary edema, there is therefore more fluid in the lung tissue or in the lungs directly. This disease is usually caused by other diseases, such as cardiac insufficiency (heart failure) or various kidney diseases. Pulmonary edema should be examined and treated by a doctor as soon as possible, otherwise serious complications can occur.
What is pulmonary edema?
Pulmonary edema is characterized by an accumulation of water in the lung tissue and in the alveoli, which can have various causes. These include heart failure and kidney disease, but also allergies and altitude sickness. See AbbreviationFinder for abbreviations related to Pulmonary Edema.
Pulmonary edema is a serious condition that requires medical attention. Pulmonary edema can occur acutely or develop chronically, i.e. slowly and initially unnoticed.
In pulmonary edema, water initially accumulates in the tissue between the lungs and progressively spreads to the air sacs of the lungs, called alveoli. As a result, the lungs can no longer be adequately ventilated in pulmonary edema, which impairs gas exchange and blood circulation in the case of pulmonary edema.
Causes
In most cases, the causes of pulmonary edema are cardiac weakness or insufficiency or kidney diseases that impair kidney function or other diseases. Therefore, a distinction is made between cardiogenic pulmonary edema and non-cardiogenic pulmonary edema.
When a heart is unable to work properly, blood flows into the left ventricle without the heart being able to pump it back into the bloodstream. As a result, the pressure in the pulmonary veins increases. If the pressure is over 25 mmHG, the lung function is severely impaired. Water is forced out of the pulmonary capillaries into the surrounding tissues, causing pulmonary edema.
Non-cardiogenic diseases can be caused by allergies, malnutrition and liver and kidney diseases and altitude sickness are possible causes of pulmonary edema.
In general, the causes of pulmonary edema lie in a disturbance in the pressure conditions, i.e. between oncotic and hydrostatic pressure within the lungs.
Symptoms, Ailments & Signs
The symptoms of pulmonary edema depend on the causes that led to the edema and the stage of the disease. In heart disease with fluid retention in the lungs, the main symptoms are cough and shortness of breath. Foamy or bloody sputum may also accompany the cough.
Other symptoms are accelerated breathing, shortness of breath during physical exertion or even at rest. The skin can appear pale, states of anxiety and restlessness can occur, the chest hurts and heart palpitations and cardiac arrhythmias can occur, blood pressure can be high or low. In severe cases of pulmonary edema, a distinct rale can be heard.
Acute pulmonary edema occurs suddenly, in addition to the other symptoms, those affected suffer from feelings of suffocation and sweating and should be treated immediately in the hospital. Pulmonary edema due to heart muscle weakness usually develops gradually and the symptoms slowly increase. They are similar to those of acute pulmonary edema, but there is also fluid retention, particularly in the legs, and this leads to weight gain.
In most cases, those affected find it harder to breathe when lying down and wake up at night because of shortness of breath, which improves again when they straighten their upper body. In general, it can lead to physical weakness and a loss of appetite.
course of the disease
Infogram of the different lung diseases and their characteristics, anatomy and location. Click to enlarge.
In the course of a pulmonary edema, hydrostatic pressure is the pressure of the blood in the capillary vessels of the body. The protein components in the blood are responsible for the oncotic pressure. If the hydrostatic pressure in the capillaries increases or if the oncotic pressure decreases, water escapes from these capillaries into the surrounding tissue.
In the lungs, it accumulates in the lung tissue or alveoli. If this process continues, up to two liters of water can accumulate, which drastically impairs lung function and is referred to as pulmonary edema. If pulmonary edema is present, the general condition will gradually or acutely deteriorate and breathing problems must lead to a doctor’s consultation in order to initiate immediate treatment.
The underlying diseases for the pulmonary edema hardly recede on their own and must be treated in intensive care medicine. If the pulmonary edema is not treated, pneumonia can occur as a complication. In general, life is at risk with pulmonary edema, especially when heart failure is the cause.
Complications
Pulmonary edema is a very serious disease that must be treated by a doctor in any case. Without treatment, the patient usually dies. The life expectancy of those affected is also significantly restricted and reduced by the pulmonary edema. However, the further course of the disease depends heavily on the cause of this complaint.
The patients primarily suffer from inner restlessness and shortness of breath. It also leads to tiredness and exhaustion. Those affected can no longer carry out physically demanding activities and suffer from reduced resilience. Coughing and heart palpitations continue. In the worst case, the person affected loses consciousness or suffers cardiac death.
Furthermore, if left untreated, pulmonary edema leads to pneumonia, which can also be fatal for those affected. The treatment of this disease is causal. In many cases, surgical interventions are necessary. However, the further course of the disease and the chances of success depend heavily on the cause of this complaint. In many cases, the life expectancy of the patient is reduced by the pulmonary edema.
When should you go to the doctor?
Pulmonary edema is a life-threatening condition that must be treated by a doctor. The symptoms are usually so severe that treatment is essential and unavoidable. In particularly severe cases, artificial respiration is required, since breathing with pulmonary edema is very difficult. Anyone who leaves this clinical picture completely without medical care exposes themselves to great danger. Accumulation of water in the lungs is life-threatening and can also cause permanent damage. For this reason, a visit to the doctor should not be put off.
Full recovery can only be achieved with appropriate treatment. The following therefore applies: Pulmonary edema is a clinical picture that absolutely requires appropriate treatment. If you do not take the appropriate medication, you are in mortal danger. In particularly acute cases, inpatient treatment is even necessary to ensure smooth treatment. Even with immediate medical care, permanent damage can occur that can no longer be treated or eliminated afterwards.
Treatment & Therapy
Coughing, rapid breathing and a faster heartbeat are signs of pulmonary edema. For diagnosis, the lungs must be listened to, and then x-rays and possibly also a computed tomography are taken. Blood tests and heart tests as well as ultrasound scans complement the diagnostic procedures.
Intensive therapy is then initiated. Oxygen can be supplied via nasal probes, the upper body is elevated and medication must be taken. Depending on the cause, the body must be detoxified or treated for functional diseases. Dialysis may be started if you have kidney disease. Pulmonary edema must always be treated in intensive care.
Aftercare
Without medical treatment, pulmonary edema leads to pneumonia, so regular follow-up care is essential. This can also be deadly for those affected. In many cases, surgical interventions are necessary to treat the disease. However, the course of the disease and the chances of successful treatment depend on the cause of its occurrence. It is therefore advisable to take it easy and avoid excessive physical exertion. In addition, lung patients should breathe sea air if possible, and a visit to a salt cave can promise relief and promote the healing process.
Due to the reduced resilience, those affected are hardly resilient and always dependent on the help and support of relatives. Everyday tasks can no longer be carried out independently, which can sometimes lead to upsets. Sensitizing relatives and friends can help to better understand how to deal with the disease and improve cooperation.
Outlook & Forecast
Pulmonary edema develops due to an existing condition. The accumulation of water in the tissues of the lungs is therefore a symptomatic phenomenon and not an independent disease. For this reason, the prognosis is based on the overall assessment of the patient’s health. Basically, it is an intensive care emergency.
If the cause of the accumulation of water is an allergic reaction, freedom from symptoms can often be achieved by avoiding the triggering stimulus. People who suffer from altitude sickness should also avoid staying in high-altitude environments so that recovery can be permanent. In both cases, healing is not possible.
Freedom from symptoms occurs automatically when the triggers are avoided. If the pulmonary edema develops as a result of an organic disease, the overall prognosis is worse. Functional disorders of the kidneys and heart are chronic or permanent in a large number of patients. Without medical care, it is not possible to alleviate the symptoms here.
Instead, an increase in health irregularities is to be expected. In the worst case, the victim dies prematurely. Treatment of the organ disorder is associated with various risks and side effects. Nevertheless, it is currently the only possibility for improvement.
You can do that yourself
If pulmonary edema is detected, medical therapy is usually carried out immediately. Medical treatment can be supported by a number of measures.
First of all, it is advisable to follow the doctor’s instructions and, above all, to take the prescribed medication reliably in order to avoid complications. There is an increased risk of acute pulmonary edema when hiking in the mountains. If symptoms such as insomnia, shortness of breath, accumulation of fluid in the limbs or headaches appear at an altitude of over 2,400 meters, you have to descend again immediately. A doctor should then be consulted. If the edema is caused by heart disease, regular weighing is indicated. As a result, weight gain caused by any edema can be determined and clarified by a doctor. The doctor will also recommend a low-salt diet.
The person concerned should also seek advice from a nutritionist and generally ensure a healthy lifestyle. A balanced diet, regular, moderate exercise and avoiding stress can reduce the risk of many of the causative diseases. Patients who have previously suffered from pulmonary edema should consult a cardiologist or pulmonologist regularly . The family doctor can also determine edema and initiate appropriate therapy.