Pulmonary Edema

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What is pulmonary edema?

Pulmonary edema is a buildup of fluid in the lung that limits breathing. Pulmonary edema can be serious and life threatening.

The most common cause of pulmonary edema is heart disease or heart failure, which prevents the heart from pumping effectively and leads to fluid buildup in the lungs and other parts of the body. Damage to the lungs themselves can also cause pulmonary edema. Such damage may be the result of trauma, inhaled toxins, infection, or some medications. Less commonly, exercising at high altitude may lead to pulmonary edema.

The underlying cause of pulmonary edema should be rapidly identified and treated. Treatment will vary greatly depending on the underlying cause but usually includes supplemental oxygen and medication.

Pulmonary edema may be life threatening. Seek immediate medical care (call 911) for serious symptoms, such as chest pain, sweating, or severe difficulty breathing, which may be combined with pale or blue lips and wheezing. Seek prompt medical care if you are being treated for pulmonary edema but mild symptoms recur or are persistent.

What are the symptoms of pulmonary edema?

Many of the symptoms of pulmonary edema are the result of difficulty breathing. Some symptoms may be indicative of the underlying cause of pulmonary edema.

Mild symptoms of pulmonary edema

You may experience pulmonary edema symptoms daily or just once in a while. At times, any of these pulmonary edema symptoms can be severe:

  • Cough
  • Grunting or gurgling sounds when breathing
  • Lightheadedness
  • Pink, frothy mucus from nose and mouth
  • Restlessness
  • Wheezing (whistling sound made with breathing)

Serious symptoms that might indicate a life-threatening condition

In some cases, pulmonary edema can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Bluish coloration of the lips or fingernails
  • Chest pain or pressure 
  • Coughing up blood (hemoptysis)
  • Difficulty breathing
  • Difficulty speaking
  • Fainting or change in level of consciousness or lethargy
  • Frothy sputum
  • Pale skin (pallor)
  • Rapid breathing (tachypnea) or shortness of breath (dyspnea)
  • Rapid heart rate
  • Sweating

What causes pulmonary edema?

Pulmonary edema occurs when air sacs in the lungs are filled with fluid. Healthy air sacs allow oxygen that you breathe in to enter the bloodstream. In pulmonary edema, the fluid in the air sacs prevents the entry of oxygen. This results in a shortness of breath.

Cardiovascular causes of pulmonary edema

The most common cause of pulmonary edema is heart disease or heart failure. In heart disease and failure, the heart is unable to pump blood away from the lungs, which increases the pressure inside the lungs. The increased pressure causes fluid to enter the air sacs inside the lung. Cardiovascular causes of pulmonary edema include:

  • Aortic valve disease (disorder of the valve that controls the flow of blood from the heart to the aorta, the artery that leads from the heart to the abdomen)

  • Cardiomyopathy (weakened or abnormal heart muscle and function)

  • Coronary heart disease

  • Hypertension (high blood pressure)

  • Mitral valve disease (disease of the valve that controls blood flow between the upper and lower chambers of the left side of the heart)

Other causes of pulmonary edema

Damage to the lungs can also cause pulmonary edema. Damage leading to pulmonary edema may be the result of:

What are the risk factors for pulmonary edema?

A number of factors increase the risk of developing pulmonary edema. Not all people with risk factors will get pulmonary edema. Risk factors for pulmonary edema include:

  • Central nervous system injury

  • Coronary heart disease 

  • Diabetes (chronic disease that affects your body’s ability to use sugar for energy) 

  • High altitude

  • Hypertension (high blood pressure)

  • Infection

  • Inhaled toxins

  • Obesity

  • Severe trauma

  • Valvular disease

Reducing your risk of pulmonary edema

You may be able to lower your risk of pulmonary edema by:

  • Eating a diet that is low in sodium, saturated fat, trans fat, and cholesterol

  • Participating in a regular exercise program

  • Quitting smoking

How is pulmonary edema treated?

Treatment of pulmonary edema includes the administration of concentrated oxygen through a face mask, prongs (tiny plastic tubes) in the nostrils, or a breathing tube, depending on the severity.

The underlying cause of pulmonary edema should be rapidly identified and treated. Treatment will vary greatly depending on the underlying cause. For example, treatment of pulmonary edema due to heart failure will aim at stabilizing the heart, while treatment of pulmonary edema due to bacterial pneumonia will aim at controlling the infection with antibiotics.

Medications to treat pulmonary edema

Depending on the underlying cause and severity of your pulmonary edema, your doctor may prescribe a variety of different medications including:

  • Antibiotics, which fight infection

  • Antihypertensive medications, which lower blood pressure

  • Digoxin, which increases the heart’s pumping ability

  • Diuretics, which help the body eliminate fluids

  • Pain control medications or sedatives, which reduce anxiety and decrease the body’s demand for oxygen

What are the potential complications of pulmonary edema?

Complications of untreated or poorly controlled pulmonary edema can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of pulmonary edema include:

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 18
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Pulmonary edema. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001195/
  2. Heart failure. Medline Plus, a service of the U.S. National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/000158.htm
  3. Ware LB, Matthay MA. Clinical practice. Acute pulmonary edema. N Engl J Med 2005; 353:2788.
  4. Bope ET, Kellerman RD (Eds.) Conn’s Current Therapy. Philadelphia: Saunders, 2013.
  5. Domino FJ (Ed.) Five Minute Clinical Consult. Philadelphia: Lippincott Williams & Wilkins, 2013.
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