Heart & Stroke Conditions Explained

Definition

Pulmonary oedema

Pulmonary oedema is the medical term used to describe the circumstances where the lungs fill with excess fluid, making it difficult to breathe and get enough oxygen into the blood.

In most cases, it happens as a result of severe heart problems.

Pulmonary oedema develops over time in the presence of heart failure or can appear suddenly (acute pulmonary oedema).

If this happens suddenly it is a medical emergency and needs immediate treatment.

Symptoms

Pulmonary oedema

Symptoms depend on the underlying cause and whether it develops suddenly or over time.

These include:

  • (Extreme) shortness of breath and difficulty breathing
  • Wheezing or gasping breath
  • A sense of suffocation
  • Anxiety and restlessness
  • Cough which may produce frothy blood stained sputum
  • Chest pain if caused by coronary heart disease
  • Often a rapid pulse

 

Causes

Pulmonary oedema

Our lungs are made up of numerous small air sacs called alveoli. These air sacs fill with each breath, taking in oxygen and releasing carbon dioxide.  If the alveoli are filled with fluid instead of air, oxygen cannot be absorbed into the blood stream.

Veins carry blood back to your heart. This blood is low in oxygen as it has travelled around your body. It returns to the right side of your heart where the right ventricle then pumps the blood into your lungs.

The blood absorbs oxygen in your lungs and then returns to the left side of your heart. If the left side of your heart is damaged or overworked leading to heart failure, it may be unable to pump enough of the blood it receives out around the body, and back pressure into the lungs follows. This back pressure forces the fluid into the alveoli sacs. This is called cardiogenic pulmonary oedema and is usually the result of coronary artery disease, cardiomyopathy, heart valve problems, uncontrolled and untreated high blood pressure.

Pulmonary oedema can also be caused by non-cardiac conditions but the mechanism is somewhat different. These include acute respiratory distress syndrome, high altitudes, nervous system diseases, adverse drug reactions, pulmonary embolism, viral infections, chest trauma, and exposure to toxins.

Prevention

Pulmonary oedema

Pulmonary oedema itself is not always preventable.

Reducing your risk factors for heart disease will help prevent subsequent heart failure. Lifestyle changes can also help you manage your symptoms and reduce your discomfort.

Not smoking

Controlling high blood pressure

Eating healthy food and keeping your cholesterol under control

Avoiding excess alcohol consumption

Maintaining a healthy weight

Staying physically active

It is important that you recognise the early signs of fluid retention which are responsible for many of your symptoms, so that prompt treatment can begin.

Diagnosis

Pulmonary oedema

Pulmonary oedema is initially diagnosed on the basis of your symptoms and a physical examination. Prompt treatment is needed so your doctor will ask about your past medical history which may increase your risk, particularly if you have cardiovascular disease or lung problems. Initial tests will include ECG, chest xray, blood tests, and a measure of your blood oxygen level.

Treatment

Pulmonary oedema

Pulmonary oedema which develops over time is associated with heart failure and a combination of medications and lifestyle changes will help reduce congestion (fluid build-up).

Acute pulmonary oedema is a medical emergency and urgent treatment is required.  It can sometimes be fatal. Prompt treatment for pulmonary oedema and treatment for the underlying cause improves the outcome.

Initial treatment is with oxygen therapy, intravenous medications to reduce the fluid build-up and possibly drugs to improve the pumping ability of the heart when a heart problem is the underlying cause.

Support for You

Pulmonary oedema

The Irish Heart Foundation offers a range of free support services to those affected by heart disease or stroke that can greatly improve their quality of life. These include support groups, physical exercise classes, therapy sessions and more.

For more information on these supports, see our Patient Supports page.

If you have any questions about heart disease or stroke, you can also call the Irish Heart Foundation’s Nurse Support on (01) 668 5001 to speak to a nurse specialist who will answer your questions, and give you guidance and reassurance.

Resources

Pulmonary oedema

Read our resources for further information:

Have a look at our selection of Ways To Live Life Better articles that cover everything from healthy eating, to being active, reducing alcohol and salt, and quitting smoking.

 

 

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