What Is Pulmonary Edema?


Pulmonary edema, or fluid in the lungs, is a condition caused by excess fluid collecting within the lungs themselves. Our lungs contain many small elastic sacs called alveoli. These air sacs expand with each breath and tend to take in oxygen while releasing carbon dioxide.  This allows oxygen to reach all our vital organs and is necessary for the functioning of organs within the body and necessary for remaining alive. This exchange of gases occurs constantly at rest, with every breath without a person ever even noticing it. However, sometimes due to disease these air sacs begin to become filled with fluid instead of air. This not only prevents adequate oxygen from being absorbed into the bloodstream but also causes severe distress to a patient. This fluid which can be of different types can collect within the numerous air sacs that are present within the lung eventually making it difficult for a patient to breathe.


Fluid in the lungs can collect for many reasons including infections such as pneumonia, exposure to toxins or toxic materials, injury, or trauma to the area of the chest or to the chest wall, a patient experiencing a sudden rise in altitude at rest or while exercising at higher elevations and is also seen in certain heart conditions. This collection of fluid in the air sacs is called pulmonary edema.


Pulmonary edema can develop either suddenly in which case it is called acute pulmonary edema and can be considered a medical emergency which can lead to death if it is not attended to in a time sensitive manner. If it develops over a longer period it is known as chronic pulmonary edema. Pulmonary edema is a very treatable disease entity and can be treated quickly and effectively. In some circumstances treatment may requires the use of medication and may also require the use of additional or supplemental oxygen.


What are the symptoms of acute pulmonary edema? How quickly can they become evident?


In pulmonary edema signs and symptoms may occur very suddenly or may develop gradually over a longer period. The types of symptoms a patient may experience may depend on the type of pulmonary edema that is present.


The symptoms may be different for individuals who have sudden or acute pulmonary edema and may include difficulty of breathing or extreme shortness of breath that may worsen with activity or also may worsen when a patient is lying down flat. There may be a feeling of suffocation or drowning. There may be wheezing or gasping for breath. The patient may have cold clammy skin accompanied by a sensation of anxiety or restlessness. Patients may have bluish lips and bluish fingertips due to inability to deliver oxygen to different parts of their body. An irregular, and often fast heartbeat may be seen. Cough that might produce a frothy kind of sputum or sputum that might possibly be tinged with blood may also be seen.





What are the symptoms of chronic pulmonary edema? How do they become evident?


Long term or chronic pulmonary edema signs and symptoms might be similar in some ways and might be different in others to those seen in sudden or acute pulmonary edema. Symptoms may include a difficulty in breathing with activity or also when lying flat. Patients may have trouble breathing while sleeping and may awaken at night with a sense of breathlessness. This breathlessness might be relieved by their ability to sit upright in bed and worsen again when lying down. Patients may experience rapid weight gain as well as swelling within their lower extremities such as their calves and feet. Patients may experience fatigue or a new cough or wheezing.


What is High Altitude Pulmonary Edema? (HAPE)


High altitude pulmonary edema known as HAPE has different signs and symptoms than pulmonary edema due to other causes. This can occur in adults or children who have traveled to high altitudes  and the symptoms can be similar to acute pulmonary edema but in many situations headache may be the very first symptom followed by shortness of breath with activity and a decreased of shortness of breath at res. This can progress to shortness of breath that can occur even while at rest. A dry cough could be experienced by the patient which then progress is to become a frothy cough as is seen in other cases of pulmonary edema. Patients may experience a very rapid heartbeat including weakness or chest pain and may also experience low grade fever. These symptoms tend to worsen at night.


It is important to see a doctor, especially a chest specialist or pulmonologist if the pulmonary edema comes on suddenly. This sudden increase in fluid in the air sacs is a medical emergency which is also considered to be life threatening. It is critically important to try to get help immediately. Pulmonary edema is not a condition that should be managed at home. For the safety of the patient acute pulmonary edema requires in hospital care.


Should you need to see a pulmonologist or critical care intensivist, please call The Chest Clinic- Dr. Javed Husain & Associates. We offer both online video consultation as well as outpatient clinic and in-hospital care for all our patients. To make an appointment please call +923018479066 or leave us a message by WhatsApp requesting an appointment and a member of our team will call back and connect with you.