Pulmonary oedema is a medical condition that involves the most important respiratory organ – the lungs. Oedema is a swelling that is caused by the accumulation of fluid inside the lung tissue. The medical condition is mainly connected to heart problems among elderly individuals, although it may have alternative causes.
This is a serious medical problem that demands immediate medical attention. The accumulation of liquid inside the lungs causes shortness of breath that can be severe or even life threatening.
What is Pulmonary Oedema?
Typically, fluid is found inside the blood vessels. Sometimes, it is possible for the fluid to pass from the blood vessels into the surrounding tissue. This is when swelling occurs. In the case of pulmonary oedema, liquids pass from the small blood vessels into the alveoli.
The accumulation of fluids inside the alveoli interferes with the exchange of oxygen and carbon dioxide inside the lungs. As a result, people suffering from pulmonary oedema experience breathing difficulty and poor oxygenation.
The cause of pulmonary oedema determines the specific alveoli that will be affected by the medical condition. In the case of heart failure, liquid will begin accumulating into the base of the lungs. When the oedema is connected to a respiratory condition, the liquid will be accumulating in the alveoli throughout the lungs.
This respiratory problem is a very common one, especially among elderly people. The fact that the number of people suffering from heart failure is on the rise is also signifying that the occurrence of pulmonary oedema has increased.
According to the World Health Organization (WHO), pulmonary oedema causes the death of more than 16,500 people worldwide on an annual basis. The medical condition affects mainly the elderly and the statistics show that 53 percent of the pulmonary oedema cases involved individuals aged over 75. Nearly 70 percent of the people that demanded medical assistance for pulmonary oedema required hospitalisation. The condition is slightly more prevalent among women, WHO statistics show.
Causes of Pulmonary Oedema
As already mentioned, heart failure is one of the most common causes of pulmonary oedema. The accumulation of fluid in the lungs will usually take place if the pulmonary blood pressure reaches values of 15 mmHg or even higher.
Some of the most common causes of pulmonary oedema include:
- Congestive heart failure
- Abnormal heart valves
- Severe arrhythmia
- A heart attack
- Acute respiratory disease syndrome (ASRD)
- Kidney failure
- Intracranial haemorrhage
- A heroin overdose
- Pulmonary embolism
- Pleural effusion
These main causes show that pulmonary oedema is connected mainly to the direct damage to the lung tissue, a cardiovascular condition that interferes with the proper passage of blood inside the blood vessels and the lack of sufficient amounts of protein that hold on to the fluid in blood plasma. Lack of protein is mostly caused by kidney problems and kidney failure.
Main Symptoms of Pulmonary Oedema
Pulmonary oedema is a serious medical condition and as such, it is connected to a number of distinguishable symptoms.
In the very beginning, the patient will probably be experiencing shortness of breath that will rapidly become worse. The breathing becomes shallow and irregular. Bloody phlegm is another very common pulmonary oedema symptom. Emergency medical care will be needed because pulmonary oedema can cause death.
Additional symptoms that may indicate pulmonary oedema include anxiety, paleness, excessive sweating, swelling in the legs and particularly in the ankles, nocturnal dyspnea and orthopnea – breathing difficulty when the person is lying down.
Rapid reactions are needed in the case of suspected pulmonary oedema. The patient will be subjected to a series of tests and exams that can confirm the condition and its severity.
Some of the commonly used diagnostic methods include a chest X-ray, blood tests that will determine the level of oxygen, electrocardiogram to rule out a heart attack or another medical problem connected to the functioning of the heart and echocardiogram.
In the case of pulmonary oedema, the X-ray will show excessive whiteness in the lung area, where the tissue should be located. In the case of severe oedema, the whitening covers almost the entire lung area.
Doctors will also rely on the patient’s medical history that will provide some additional information about specific medical conditions and problems that could results in pulmonary oedema. A doctor may also decide to use a pulmonary artery catheter to distinguish between lung oedema caused by cardiovascular problem and the one that is connected to other conditions.
The treatment of pulmonary oedema should initially focus on facilitating the breathing of the patient and increasing oxygenation. In very severe cases, a medical team may even decide to rely on mechanical ventilation.
Diuretic medications will be efficient in most of the cases because these help the body handle the excess fluids accumulating in the lungs. A number of patients can be treated outside of a hospital, solely through the intake of oral medications.
The treatment will naturally be dependent on the cause of the pulmonary oedema. Medicines and procedures needed in the case of kidney failure will differ from the ones that will be prescribed in the case of pulmonary oedema caused by an infection. After stabilizing the patient, the doctors will try to determine the specific cause in order to provide adequate treatment.
Pulmonary Oedema Prognosis
The underlying cause of pulmonary oedema will be largely determining for the prognosis.
Pulmonary oedema that is left untreated can easily lead to respiratory arrest that will have a lethal outcome. A person that suspects such a problem due to the shortness of breath should immediately seek the assistance of a medical professional.
Untreated oedema can also lead to complications, especially to ones connected to the main cause of the problem. Hypoxia is the one that most doctors are concerned with because poor oxygenation can result in death.
It is difficult to come up with specific preventive measures that will diminish the chance of pulmonary oedema taking place. People that are experiencing cardiovascular problem should undertake steps that will improve heart health and minimize the chance of an attack or another serious condition. Causes like acute respiratory disease syndrome are almost impossible to prevent.