Pulmonary Hypertension in Congenital Heart Disease: A Scientific Statement From the American Heart Association
What Is Pulmonary Edema?
Pulmonary edema is a serious condition that occurs when the lungs fill with fluid. This prevents the body from gaining the oxygen it needs. It is typically caused by another condition, such as heart failure or altitude sickness.
Pulmonary edema is a condition in which the lungs fill with fluid. It's also known as lung congestion, lung water, and pulmonary congestion. When pulmonary edema occurs, the body struggles to get enough oxygen, and you may experience shortness of breath or wheezing.
Pulmonary edema can range in severity. Some people may need critical care. Often, treatment involves treating pulmonary edema along with the related underlying condition.
Timely treatment can improve possible outcomes.
Several possible health conditions and external factors can cause pulmonary edema.
Congestive heart failure
Heart failure happens when the heart can no longer pump blood properly throughout the body. This creates a backup of pressure in the small blood vessels in the lungs, which causes the vessels to leak fluid.
Typically, the lungs will take oxygen from the air you breathe and put it into the bloodstream. But when fluid fills your lungs, they cannot put oxygen into the bloodstream. This deprives the rest of the body of oxygen.
Other medical conditions
Other less common medical conditions that can cause pulmonary edema include:
External factors
Some external factors can also put pressure on the heart and lungs and cause pulmonary edema. These include:
In cases of pulmonary edema, your body cannot gain oxygen effectively. This is due to the increasing fluid in the lungs preventing oxygen from moving into the bloodstream. Symptoms may continue to worsen until you get treatment.
Symptoms depend on the type of pulmonary edema.
Long-term pulmonary edema
The symptoms of long-term pulmonary edema include:
High-altitude pulmonary edema
Pulmonary edema due to altitude sickness, or not getting enough oxygen in the air, will have symptoms that include:
You may need emergency assistance if these symptoms start to get worse. Call 911 or your local emergency services or have someone drive to you the hospital. If you may have pulmonary edema, you should not drive yourself to the hospital.
Pulmonary edema can be an emergency.
Call 911 or your local emergency services immediately for medical help if you experience any of these symptoms:
These may be symptoms of acute pulmonary edema. Acute pulmonary edema develops suddenly. If left untreated, the fluid in your lungs can cause you to drown.
If a doctor suspects you may have pulmonary edema, they may look for fluid in your lungs or symptoms caused by it. They may perform a basic physical examination and listen to your lungs with a stethoscope, looking for:
A doctor may also look for some signs on your body. These may include:
The doctor may discuss your symptoms and ask about your medical history. They may order additional tests if they believe you have fluid in your lungs.
Examples of tests used in diagnosing pulmonary edema include:
Pulmonary edema is a serious condition that requires quick treatment. Treatment for pulmonary edema may include:
Oxygen
Oxygen may be the first line of treatment for this condition, depending on the severity. A healthcare team may prop you up and deliver 100 percent oxygen through an oxygen mask, nasal cannula, or positive pressure mask.
Diuretics
In less severe cases, it may be treated with diuretics, or water pills. You may not have to stay in the hospital. This may be the case if you have congestive heart failure.
Treatment of the underlying condition
A doctor will also diagnose the cause of pulmonary edema and prescribe the appropriate treatment for the underlying cause.
Depending on your condition and the cause of your pulmonary edema, the doctor may also prescribe:
Intensive or critical care
In severe cases, people with pulmonary edema may need intensive or critical care.
In other cases of pulmonary edema, you may need treatment to help you breathe. A machine will deliver oxygen under pressure to help get more air into your lungs. Sometimes this can be done with a mask or cannula, also called continuous positive airway pressure (CPAP).
Your doctor may need to insert an endotracheal tube, or breathing tube, down your throat and use mechanical ventilation.
Pulmonary edema is sometimes confused with pleural effusion, another condition involving fluid buildup in the lungs. However, pleural effusion causes a buildup of fluids in the pleural tissues. These cover the outside of each of your lungs as well as the inside of the chest wall.
Causes of pleural effusion may include:
With pleural effusion, you may experience:
A chest X-ray can help diagnose pleural effusion. A doctor may take a biopsy from pleural tissues if they suspect cancer. Depending on the cause, pleural effusion may be treated with a combination of fluid removal techniques and surgery.
Pneumonia is another serious condition of the lungs. Unlike edema, pneumonia is caused by viral, fungal, or bacterial infection. As your lungs become infected, fluid builds up in the air sacs (alveoli).
While pulmonary edema and pneumonia cause buildup in the lungs, the former is primarily caused by CHF. Pneumonia, on the other hand, is caused by an infection. A weakened immune system can increase your chances of getting pneumonia from a common cold or flu.
Symptoms of pneumonia may include:
According to the American Lung Association, pneumonia is one of the most common causes of hospitalization in children and adults.
Pulmonary edema isn't a cause of pneumonia. However, the buildup of fluids from pneumonia can lead to pleural effusion. Pneumonia requires immediate treatment to prevent complications. It may require antibiotics and oxygen therapy.
People with heart problems or heart failure are the most at risk for pulmonary edema. Other factors that may put a person at risk include:
There is no way to fully prevent pulmonary edema. Those at high risk should seek immediate attention if they develop symptoms.
The best way to try and prevent pulmonary edema is by taking good care of your health:
You can also decrease your risk for heart failure, the most common cause of pulmonary edema with the following steps:
The outlook for pulmonary edema depends on the severity. If you have a moderate case and receive quick treatment, you will often have a full recovery. Severe cases can be fatal if you delay treatment.
Be sure to see a doctor regularly and get immediate help if you experience any pulmonary edema symptoms.
If you need help finding a primary care doctor, you can browse doctors in your area through the Healthline FindCare tool.
Pulmonary edema is a health condition when the lungs fill with fluid. This fluid can prevent the body from effectively receiving oxygen.
You may experience shortness of breath after exertion and during rest. The severity can range from moderate to severe. Pulmonary edema requires prompt medical treatment.
Pulmonary edema occurs due to another condition, most commonly congestive heart failure. Treatment may involve treating pulmonary edema and its underlying cause.
What Is Edema?
"Edema" is the medical term for swelling. Body parts swell from injury or inflammation. It can affect a small area or the entire body. Medications, pregnancy, infections, and many other medical problems can cause edema.
Edema happens when your small blood vessels leak fluid into nearby tissues. That extra fluid builds up, which makes the tissue swell. It can happen almost anywhere in the body.
Peripheral edema. This usually affects the legs, feet, and ankles, but it can also happen in the arms. It could be a sign of problems with your circulatory system, lymph nodes, or kidneys.
Pedal edema. This happens when fluid gathers in your feet and lower legs. It's more common if you're older or pregnant. It can make it harder to move around in part because you may not have as much feeling in your feet.
Lymphedema. This swelling in the arms and legs is most often caused by damage to your lymph nodes, tissues that help filter germs and waste from your body. The damage may be the result of cancer treatments like surgery and radiation. The cancer itself can also block lymph nodes and lead to fluid buildup.
Pulmonary edema. When fluid collects in the air sacs in your lungs, you have pulmonary edema. That makes it hard for you to breathe, and it's worse when you lie down. You may have a fast heartbeat, feel suffocated, and cough up a foamy spittle, sometimes with blood. If it happens suddenly, call 911.
Cerebral edema. This is a very serious condition in which fluid builds up in the brain. It can happen if you hit your head hard, if a blood vessel gets blocked or bursts, or you have a tumor or allergic reaction.
Macular edema. This happens when fluid builds up in a part of your eye called the macula, which is in the center of the retina, the light-sensitive tissue at the back of the eye. It happens when damaged blood vessels in the retina leak fluid into the area.
Things like a twisted ankle, a bee sting, or a skin infection will cause edema. In some cases, like an infection, this may be helpful. More fluid from your blood vessels puts more infection-fighting white blood cells in the swollen area.
Edema can also come from other conditions or from when the balance of substances in your blood is off. For example:
Low albumin. Your doctor may call this hypoalbuminemia. Albumin and other proteins in the blood act like sponges to keep fluid in your blood vessels. Low albumin may contribute to edema, but it's not usually the only cause.
Allergic reactions. Edema is a part of most allergic reactions. In response to the allergen, nearby blood vessels leak fluid into the affected area.
Obstruction of flow. If drainage of fluid from a part of your body is blocked, fluid can back up. A blood clot in the deep veins of your leg can cause leg edema. A tumor blocking the flow of blood or another fluid called lymph can cause edema.
Critical illness. Burns, life-threatening infections, or other critical illnesses can cause a reaction that allows fluid to leak into tissues almost everywhere. This can cause edema all over your body.
Congestive heart failure. When the heart weakens and pumps blood less effectively, fluid can slowly build up, creating leg edema. If fluid builds up quickly, you can get fluid in the lungs. If your heart failure is on the right side of your heart, edema can develop in the abdomen.
Liver disease. Severe liver disease, such as cirrhosis, causes you to retain fluid. Cirrhosis also leads to low levels of albumin and other proteins in your blood. Fluid leaks into the abdomen and can also cause leg edema.
Kidney disease. A kidney condition called nephrotic syndrome can cause severe leg edema and sometimes whole-body edema.
Pregnancy. Mild leg edema is common during pregnancy. But serious complications of pregnancy like deep vein thrombosis and preeclampsia can also cause edema.
Head trauma, low blood sodium (called hyponatremia), high altitudes, brain tumors, and a block in fluid drainage in the brain (known as hydrocephalus) can cause cerebral edema. So can headaches, confusion, unconsciousness, and coma.
Medications. Many medicines can cause edema, including:
When they cause swelling, usually it's mild leg edema.
Your symptoms will depend on the amount of swelling you have and where you have it.
Edema in a small area from an infection or inflammation (like a mosquito bite) may cause no symptoms. On the other hand, a large allergic reaction (such as from a bee sting) may cause edema on your entire arm that can bring pain and limit your arm's movement.
Food allergies and allergic reactions to medicine may cause tongue or throat edema. This can be life-threatening if it interferes with your breathing.
Leg edema can make the legs feel heavy. This can affect walking. In edema and heart disease, for example, the legs may easily weigh an extra 5 or 10 pounds each. Severe leg edema can interfere with blood flow, leading to ulcers on the skin.
Pulmonary edema causes shortness of breath and sometimes low oxygen levels in the blood. Some people with pulmonary edema may have a cough.
There may be an indent or a "pit" that remains for a while after you push on the skin in some types of edema. This is called pitting edema. If the tissue springs back to its normal shape, it's called non-pitting edema. It's a symptom that may help your doctor figure out the cause of your edema.
To treat edema, you often must treat its underlying cause. For example, you might take allergy medications to treat swelling from allergies.
Edema from a block in fluid drainage can sometimes be treated by getting the drainage flowing again. A blood clot in the leg is treated with blood thinners. They break down the clot and get drainage back to normal. A tumor that blocks blood or lymph can sometimes be shrunk or removed with surgery, chemotherapy, or radiation.
Leg edema related to congestive heart failure or liver disease can be treated with a diuretic (sometimes called a ''water pill'') like furosemide (Lasix). When you can pee more, fluid from the legs can flow back into the blood. Limiting how much sodium you eat can also help.
Everything You Need To Know About Edema
Edema refers to swelling due to fluid buildup in bodily tissues. It is common in the skin but can affect the brain, lungs, and other organs.
There are different causes and types of edema. For example, pulmonary edema affects the lungs, while pedal edema causes swelling in the feet.
Edema usually starts slowly, but the onset can be sudden. It is a common condition, but it can also be a sign of a serious condition.
This article will explain what edema is and how to recognize it, as well as the different types of and treatments for edema. It will also look at possible complications of the condition.
It most often occurs in the skin, especially in the hands, arms, ankles, legs, and feet. However, it can also affect the muscles, bowel, lungs, eyes, and brain.
Edema mainly occurs in older adults and pregnant people, but anyone can experience it.
Symptoms depend on the underlying cause, but swelling, tightness, and pain are common.
A person with edema may also notice:
Symptoms can also depend on the type of edema a person has and which part of the body it affects.
There are many types of edema. Each one can indicate a range of further health conditions.
Edema can occur in other locations as well, but those mentioned above are the most common.
Edema can result from circulatory problems, infection, tissue death, malnutrition, total body fluid overload, and electrolyte problems.
Heart failure
If one or both of the lower chambers of the heart cannot pump blood properly, blood can accumulate in the limbs, causing edema.
Kidney disease or kidney damage
The body of a person with a kidney disorder may not be able to eliminate enough fluid and sodium from the blood. This puts pressure on the blood vessels, which causes some of the liquid to leak out. Swelling can occur around the legs and eyes.
Liver disease
Cirrhosis affects liver function. It can lead to changes in the secretion of hormones and fluid-regulating chemicals and reduced protein production. This causes fluid to leak out of the blood vessels into surrounding tissue.
Cirrhosis also increases pressure within the portal vein, which is the large vein that carries blood from the intestines, spleen, and pancreas to the liver. Edema can occur in the legs and abdominal cavity.
Certain medications
Pregnancy
During pregnancy, the body releases hormones that encourage fluid retention. The body also retains more sodium and water than usual. The face, hands, lower limbs, and feet may swell.
When a person rests in a reclined position during pregnancy, the enlarged uterus can press on a vein known as the inferior vena cava. This can obstruct the femoral veins, leading to edema.
During pregnancy, the blood clots more easily. This can increase the risk of deep vein thrombosis (DVT), which is another potential cause of edema.
Dietary factors
Diabetes
Some complications of diabetes include:
Diabetic macular edema is the swelling of the retina in diabetes.
Conditions affecting the brain
Some causes of swelling in the brain include:
Allergies
Some foods and insect bites may cause edema of the face or skin in people who have allergies or sensitivities to them. Severe swelling can be a symptom of anaphylaxis.
Swelling in the throat can close a person's airway, so they cannot breathe. This is a medical emergency.
Problems with the extremities
Some extremity-related causes of edema include:
Miscellaneous conditions
Some other possible causes of edema include:
Diuretics are a type of medication. They help eliminate excess fluid by increasing the rate of urine production by the kidneys. Different types work in different ways.
A doctor will recommend a specific treatment plan for macular edema, pulmonary edema, and other types of edema.
A person with edema could also try wearing compression garments and doing specific exercises to help.
Some self-care techniques can help reduce or prevent edema.
A masseuse or physical therapist may help remove the fluid by stroking firmly in the direction of the heart.
Oxygen may be useful for treating some types of edema. For example, an individual with cardiogenic pulmonary edema may need additional oxyge n if they have difficulty taking in enough.
Edema occurs when fluid builds up in the body. This causes swelling, which can sometimes be painful.
There are several potential causes of edema, including pregnancy, heart failure, liver disease, and certain medications. The treatment a person receives will depend on the cause.
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