Capillary vessels, in turn, are very thin blood vessels, where gas exchange effectively occurs. There, oxygen binds to blood cells, and thus goes to the heart.
The heart, in turn, pumps oxygenated blood for the whole body to use. And, later, he receives it back, already deoxygenated, so that the oxygenation process is repeated.
A pulmonary edema happens when an abnormal phenomenon hinders the flow of blood in the capillary vessels, causing these vessels, in turn, to leak water into the lungs region, causing a swelling with water inside them.
Pulmonary edema can basically be divided into four types.
Are they:
Acute pulmonary edema Acute pulmonary edema, also known as acute lung edema (EAP), is an emergency situation, which needs medical attention as soon as possible.
It happens when the lungs fill with fluid from the blood vessels, causing the respiratory system to collapse.
This process makes breathing difficult and gives the patient the feeling that he is drowning. The condition is extremely serious and can lead to death quickly.
The main characteristic of acute pulmonary edema is its sudden appearance. Most of the time, it affects people who already have a history of cardiovascular problems – some relatively common, such as hypertension and heart failure.
If the patient has short, rapid breathing, coughing , a feeling of drowning, shortness of breath, blue-purple skin (especially the lips and fingertips) and agitation, it is essential to call an ambulance as soon as possible and refer you to a hospital.
Chronic pulmonary edema Chronic pulmonary edema is not a condition that happens suddenly, but that gradually evolves over time.
The most common causes for this type of pulmonary edema are heart diseases. However, some other conditions can cause chronic pulmonary edema, such as:
Lung injuries; Ingestion of certain medications; Diseases that affect the nervous system; Use of drugs; Smoke inhalation. High Altitude Pulmonary Edema (EPGA) High Altitude Pulmonary Edema (also known by its acronym, EPGA) is a complication of another pathology – Altitude Disease, also known as Mountain sickness or Hypobaropathy, which is characterized by breathing difficulties after suddenly changing altitude.
This means that a patient can develop an EPGA condition if he goes to a very high place in a short period of time. In general, changes in altitude that pose risks are greater than 2000 meters (or approximately 6500 feet).
The first symptoms may appear immediately or 24 to 96 hours after the sudden change in altitude.
Anyone is subject to developing EPGA, including young, healthy individuals. However, the risks are greater among those who have cardiorespiratory problems or have had EPGA before.
Neurogenic pulmonary edema Neurogenic pulmonary edema is a rare type of pulmonary edema, caused by diseases and trauma that affect the central nervous system.
Among the problems that can cause pulmonary edema of neurogenic origin, are meningitis, multiple sclerosis, substance overdose, head trauma and spinal cord injury.
Read more: Edema: what it is, types and treatments
Your lungs and cardiovascular system work together to oxygenate the body’s cells. Therefore, the functions of the heart and lung are closely linked.
The heart has two departments: one responsible for directing blood flow without oxygen exclusively to the lungs, and the other that must pump properly oxygenated blood throughout the body.
Blood without oxygen is called venous , while oxygenated blood flow is called arterial .
The function of the lungs is to oxygenate the blood it receives from the “first department” of the heart and return it oxygenated to the “second department”, so that the rest of the body can receive blood with oxygen to continue working.
This means that, for its two departments to perform its functions perfectly, the heart depends directly on the lung. In contrast, the lung also needs a healthy heart to continue doing its job.
That is why heart and breathing problems (such as pulmonary edema, for example) are directly related.
The causes of pulmonary edema may or may not be directly related to heart problems.
Possible causes of the problem include:
Cardiogenic causes Cardiogenic causes are related to cardiovascular problems. This means that, in these cases, pulmonary edema is caused by some heart disease that congests the pulmonary vessels. This process causes the water in the blood to invade the pulmonary alveoli.
Failures in the functioning of the heart, in general, are mainly responsible for pulmonary edema.
They can be:
Hypertension High blood pressure causes several health problems, many of which directly affect the heart and blood circulation, which affect the functioning of the lung.
Therefore, hypertension may be the original cause of pulmonary edema.
Cardiac insufficiency Heart failure is a chronic disease that, as the name suggests, makes the heart not work enough to supply the body’s needs.
In some cases of heart failure, the heart cannot pump enough blood (a movement called systole ). In others, it is unable to fill with non-oxygenated blood ( diastole ), which should be sent to the lung.
The disease is a major cause of pulmonary edema.
Coronary artery disease Also called Atherosclerosis and Coronary Disease , this problem causes fatty plaques (clinically called atheroma ) to accumulate in the blood vessel walls of the heart.
This causes the blood flow to fail to pass and reach the heart, which, in turn, needs to pump blood to the lung.
In addition to causing pulmonary edema, coronary artery disease can also cause myocardial infarction.
Cardiomyopathy Cardiomyopathy is a problem that can trigger heart failure, which, in turn, can cause pulmonary edema.
People with the disease have swollen and inflamed heart tissue. This inflammation, in turn, weakens the walls of the organ, which cannot pump enough blood to the rest of the body or make gas exchanges with the lung, which are necessary to oxygenate blood flow.
Heart valve problems The heart has four valves: tricuspid, pulmonary, mitral and aortic . These valves act as elements that “push” the blood forward, preventing the blood flow from returning to the heart after it has been pumped.
When these valves stop working, or don’t work as they should, the oxygenation process in the blood is compromised – which directly affects the lung and can cause pulmonary edema.
Myocardial infarction Popularly called a heart attack , myocardial infarction is a problem that occurs when an artery is “clogged” by a blood clot.
This obstruction in the middle prevents the blood from reaching the heart. The cardiac tissue without blood supply, in turn, ends up dying.
Myocardial infarction can cause pulmonary edema because arterial obstruction can lead to sudden heart failure – which, in turn, is one of the main reasons for the development of pulmonary edema.
Non-cardiogenic causes Non-cardiogenic causes are those that are not directly related to the heart.
Are they:
Lung injuries caused by infections Some lung infections (caused by bacteria, fungi and mainly viruses), including pneumonia
These lesions alter the permeability of the lung tissue, making the organ more susceptible to water entry, causing edema.
Renal insufficiency Renal failure is a disease that characterizes the loss of the main ability of the kidneys: that of filtering solid and liquid waste from the body.
The condition can cause an accumulation of fluid in the blood vessels. These liquids can end up “leaking” to other organs, causing edema in various parts of the body – including the lung.
Central nervous system conditions Injuries and diseases that affect the central nervous system (and, especially, that can increase intracranial pressure) can be responsible for an accumulation of fluid in the lungs. Pulmonary edema with this type of origin is called neurogenic pulmonary edema .
Although there are few studies on the incidence of neurogenic pulmonary edema, it is known that some conditions that can cause the problem are:
Spinal injury The spinal cord is a kind of elongated stem that functions as an extension of the central nervous system. It is basically the path taken by the brain’s nerve impulses towards the whole body.
Spinal cord injuries are usually caused by accidents and falls. Because of the importance of this part of the body, trauma can affect several regions of the body. In the respiratory system, some possible complications are pulmonary edema, infections and atrophies.
Head trauma (TBI) Head trauma (also known by the acronym, TBI) occurs when there is a significant injury to the brain, usually caused by events such as blows, traffic accidents, gunshots, among others.
Pulmonary complications such as airway obstruction and acute pulmonary edema are common in cases of TBI. Some studies suggest that the cause for this is the increase in intracranial pressure, which destabilizes several organs in the body.
Aneurysms There are several reports of acute pulmonary edema during the aneurysm embolization process – a surgical process in which the aneurysm is dilated through the use of a catheter.
Malformations of cerebral arteries Arterial malformations are congenital problems that can hinder oxygen transport, leading to serious brain, cardiac, and, of course, pulmonary complications.
Multiple sclerosis Multiple sclerosis is an autoimmune disease that affects the central nervous system and can cause several problems in the body.
Pulmonary edema can be caused by multiple sclerosis. However, this source of the problem is rare.
Medicines Excessive use of Aspirin can cause pulmonary edema.
Pulmonary edema caused by taking too much Aspirin can happen both in the form of an overdose (when a person takes too many pills at once) or by chronic use of the drug (which occurs when a patient takes too many Aspirin pills in the long term, little by little).
Use of drugs Overdosing on drugs like cocaine and methadone can also be the cause of pulmonary edema.
Altitude With changes in altitude, the heart and lungs need to make an extra effort to absorb the amount of oxygen they need in order for the body to continue functioning.
Therefore, sudden changes in altitude can be the cause of pulmonary edema. In such cases, the disease is called High Altitude Pulmonary Edema (EPGA).
Smoke inhalation Carbon monoxide is a flammable gas that is present in smoke from burning coal and fossil fuels.
Inhaling this smoke in excess can cause pulmonary edema, acute or even chronic.
Drowning Drowning in seas, rivers, pools and lakes are agents that cause pulmonary edema. After all, drowning is literally filling your lungs with water.
It is estimated that somewhere between 30% and 44% of patients hospitalized after drowning present with pulmonary edema.
Some people with certain health and behavioral histories may be more susceptible to developing pulmonary edema, including:
People with cardiorespiratory diseases; Hypertensive; Elderly people, who are more prone to heart failure; People who use Aspirin in excess; People who are in the habit of climbing mountains and peaks. The symptoms of pulmonary edema vary according to the type of the disease.
Can be:
Symptoms of acute pulmonary edema Short breath; Shortness of breathe; Need to draw air, trying to take a deep breath; Cough, which may or may not be accompanied by blood; Drowning sensation; Anxiety; Changes in heart rate, which, in general, are faster than normal; Chest pain. Symptoms of chronic pulmonary edema Shortness of breath when making physical effort; Difficulty breathing when you lie down; Wheezing in the chest; Waking up in the middle of the night with a feeling of drowning and / or shortness of breath; Swelling in the legs, feet and hands; Fatigue; Weight gain without justification. Symptoms of High Altitude Pulmonary Edema Sudden headache, whose intensity escalates rapidly; Difficulty breathing; Cough; Irregular and faster heart beats than normal; Discomfort or discomfort in the middle of the chest; Difficulty balancing and walking; Sudden fever. Given the severity of pulmonary edema, as soon as symptoms of the disease are detected, the patient is likely to be referred for urgent examinations.
Among the tests that may be ordered by the doctor, are:
Bloodtests Blood tests can be performed to measure the oxygen and carbon dioxide levels in the patient’s blood. The reference values for both substances are used to indicate that the body’s breathing process is working properly.
Another blood test that can be ordered is the B-type Natiuretic Peptide (BNP), which can indicate whether an acute pulmonary edema is related to a heart problem.
Pulse oximetry Pulse oximetry is a quick and simple test that can show how much oxygen is circulating in the patient’s bloodstream.
The test is done using a small electronic device called a pulse oximeter , which can be placed on the tip of the index finger or the earlobe. The result comes out on time.
X-ray of the chest and lungs This type of examination is requested so that the doctor can have an overview of the patient’s chest and lungs, assessing whether there is indeed pulmonary edema and excluding other possible diseases or phenomena that could be causing the symptoms.
Electrocardiogram If the doctor suspects that the cause of your pulmonary edema is cardiogenic, he will likely order an electrocardiogram .
The test is used to measure the electrical impulses of the heart. These data can indicate a number of heart problems, including myocardial infarctions.
Echocardiogram The echocardiogram works as a kind of ultrasound of the heart, which mainly assesses how is the blood flow that passes through the organ.
There are several types of echocardiogram, which can be ordered according to the hypothesis of the doctor responsible for the patient.
If your condition of pulmonary edema is stable, your doctor will likely need to talk to you about your health history.
It is essential to be totally honest and remember to communicate to the professional about details such as:
How long have you been experiencing symptoms of pulmonary edema; How intense and frequent are your symptoms; Any behavior or habit that appears to intensify your symptoms; If you have already been diagnosed with sleep apnea, asthma and / or Chronic Obstructive Pulmonary Disease; If you have already experienced symptoms of sleep apnea (snoring, shortness of breath at night, drowsiness during the day, insomnia and morning headache, for example); If you smoke or used to smoke in the past; What is your physical exercise routine; If you are in the habit of climbing mountains, hiking or traveling to cities at higher altitudes than the city in which you reside, and if you have done so recently. A picture of pulmonary edema is severe and inspires emergency and strict care, but, yes, the disease has a cure . The problem can even be reversed even when it appears in acute form.
The priority in a treatment of pulmonary edema is to improve the patient’s breathing capacity, keeping oxygen levels under control.
Then, health professionals will try to map the cause of the edema and keep it under control. Treating the cause is the main way to treat pulmonary edema.
Oxygen Providing oxygen to the patient is generally the first concern of the medical team in any case of hospitalization for pulmonary edema.
Depending on the case, the professionals involved in the treatment may recommend the use of oxygen masks and cannulas, or even mechanical ventilation in slightly more serious cases.
In addition, the oxygen levels of the patient with pulmonary edema should be constantly monitored.
Hemodialysis In cases of acute pulmonary edema, the medical team may recommend emergency hemodialysis.
Hemodialysis is a process in which, basically, a machine reinforces the work of filtering liquids done by the kidneys. Through it, it is possible to drain about a liter of water from the lungs in half an hour.
Aspiration When necessary, fluids can be aspirated from the lungs through a tube inserted into the throat.
The remedies given to the doctor in cases of pulmonary edema will be directly related to the cause of the disease.
Some medications that can be prescribed to relieve the symptoms and the progression of the pulmonary edema itself are:
Anti hypertensive Anti hypertensive drugs are remedies used to keep blood pressure under control.
Diuretics Diuretics are remedies used to increase urine production and the consequent elimination of fluid from the body.
Chloran ; Diovan HCT ; Natrilix SR ; Complementary Medicines Attention!
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
Maintain a healthy lifestyle So far, nothing new: you need to eat healthy and exercise regularly, according to your doctor’s instructions. Redoubled care with the dynamics of your lifestyle is an important step in living with a picture of pulmonary edema.
Avoid habits that can worsen pulmonary edema Smoking, maintaining a climbing and hiking routine in places with very high altitudes and using drugs are habits that tend to be extremely harmful and dangerous to people with pulmonary edema.
Treat the cause of your condition In most cases, pulmonary edema is directly related to another health condition. Therefore, it is important to detect the source of the problem and keep it under control.
Medical follow-up is essential The picture of pulmonary edema inspires care. So it is important to visit a doctor regularly for tests and to check how things are going.
Keep an eye on blood pressure and glucose levels Hypertension and diabetes are conditions that require care naturally. In people with a history of pulmonary edema, this need is even greater to avoid serious problems. Keep blood pressure and glucose under control.
Hypoxia Hypoxia is the clinical name for a condition characterized by low levels of oxygen in the body’s tissues.
A hypoxia picture means that some obstruction is preventing the transport of oxygen throughout the body – in the case of patients with pulmonary edema, the problem itself.
The main symptom of hypoxia is the purple tinge (cyanosis) on the lips, nails and fingertips. The problem can also cause fatigue , insomnia , headaches, poor appetite, dizziness and, in some cases, diarrhea .
Hypoxia is a serious complication that can affect the patient’s psychomotor skills (causing limited movement or speech ability, for example), in addition to having the ability to lead to fainting, heart attack, coma and death.
Acute Respiratory Discomfort Syndrome (ARDS) Acute Respiratory Discomfort Syndrome (ARDS) is a type of lung failure caused by the accumulation of fluids inside the lung. The condition causes the lung to collapse and release defective proteins into the bloodstream, damaging other organs in the body as well.
ARDS can cause severe heart and lung damage, coma, multiple organ failure and death.
Pulmonary hypertension Pulmonary edema can cause Secondary Pulmonary Hypertension, an unhealed condition that consists of increased intrapulmonary pressure.
Patients with pulmonary hypertension can develop pulmonary and cardiac failure. In addition, people who do not respond to drug treatment may need a lung transplant.
Pleural effusion In the lung, there are two thin membranes called pleurae. One of them is located inside the organ and goes by the name of visceral pleura; the second line covers the chest wall and is called the parietal pleura.
Within the space that separates the two pleurae, there is a small amount of liquid, which must be there naturally to facilitate the expansion of the lungs during the breathing process.
When there is an excessive amount of fluid between the pleurae, a condition called pleural effusion is established .
A pleural effusion, in turn, can cause lung failure, generalized infections (also called sepsis or septicemia), coma and death.
Death If not treated quickly or adequately, pulmonary edema can lead to death.
A study published by doctors at Jonscher Hospital, in Poland, pointed out that 21% of patients admitted to the unit with pulmonary edema pictures ended up dying.
It is difficult to prevent pulmonary edema itself. The way out is to seek the prevention of situations that can cause or favor the appearance of the problem.
Some measures that can be taken are:
Visit a cardiologist regularly One of the best ways to prevent pulmonary edema is to keep heart disease under control.
If you have been diagnosed with a heart condition, it is important to have regular medical follow-up and follow the treatment correctly.
Keep an eye on your blood pressure Hypertensive patients need to keep the situation under control to avoid a series of health problems, including pulmonary edema.
Therefore, it is important to take the medications indicated by the doctor to control blood pressure, avoid eating very salty foods and follow all the recommendations of the professional who accompanies the case.
Eat well Eating healthy, balancing the levels of sugars, salt and fats, can make a big difference in preventing various diseases that affect the heart and lungs.
Do not smoke Smoking is the causative agent of several cardiorespiratory problems, including acute pulmonary edema.
Exercise Studies indicate that regular physical activity strengthens the lung and all the muscles of the respiratory system, avoiding problems in that part of the body (and many others!).
Get check-ups If you are in the habit of facing adventures in peaks and mountains, it is important to see a doctor to check if everything is fine with your health at least once a year.
The care should be even greater if you already have a history of EPGA, with constant monitoring by a cardiologist.
Attention to health history Speaking of history of EPGA, it is also essential to maintain heightened attention if you already have other cardiorespiratory problems. Discuss with your doctor whether betting on climbing and hiking is best for your health.
Climb calmly Sudden changes in altitude are the main cause of an EPGA picture. So it is important to climb hills, peaks and mountains calmly – especially if you are a beginner.
People who started the activity a short time ago should stop to rest and get used to the change of altitude every 300 or 600 meters of climb, according to the level of experience.
For larger climbs, it is important to climb a maximum of 1,200 meters per day, during the first two days of the journey. After the second day, the mountaineer should limit himself to climbing about 400 meters a day.
More important than convention is to climb at a pace that is comfortable for the mountaineer, knowing your own limits and knowing when to stop and retreat.
Watch your food Some research suggests that avoiding foods with a lot of salt, drinking plenty of fluids and not drinking alcohol during incursions to higher altitudes can drastically reduce the risk of pulmonary edema.
Invest in fitness Research that links adequate physical conditioning to the prevention of altitude-related pulmonary edema is still scarce, but it still exists. Therefore, not taking a step higher than your legs and respecting the limits of your body is essential.
The preparation for climbing is essential. If possible, also invest in medical follow-up during your preparation.
Can pulmonary edema lead to death? Yes , pulmonary edema is a condition that can lead to the patient’s death.
Therefore, it is very important that people who show symptoms of the disease (or who have already been diagnosed with chronic pulmonary edema and feel a sudden worsening) be rescued as soon as possible .
What is the difference between pulmonary edema and pulmonary emphysema? Despite similar names and symptoms, pulmonary edema and pulmonary emphysema are quite different diseases.
While pulmonary edema is caused by the accumulation of fluid in the lungs, pulmonary emphysema is characterized by a loss of elasticity in the organ walls.
Another crucial difference is that, for pulmonary edema, there is a possibility of cure. Pulmonary emphysema – which mostly develops through the use of cigarettes – is incurable.
What is the difference between pulmonary edema and water in the lung? “Water in the lung” is a popular nomenclature for pulmonary edema. However, the term can also refer to another disease, called pleural effusion.
Can air travel cause pulmonary edema? It is rare that flying in a plane causes a picture of High Altitude Pulmonary Edema (EPGA) in a healthy person. This is because the air cabins are pressurized – that is, they have their internal pressure artificially regulated so that the human organism is comfortable and is able to absorb the necessary amounts of oxygen during the trip.
However, people who already have a diagnosis of cardiovascular and respiratory problems or who have a history of EPGA need to be a little cautious before planning an air trip, because there is a greater risk of problems occurring there.
If this is the case, it is important to discuss travel plans with your doctor and ask if the plane is the most suitable means of transport for you, according to your health history.
You also need to notify the airline about your condition at the time of booking the airline ticket, or at most 72 hours before departure. Thus, the crew can prepare to provide the necessary first aid in case any eventuality involving their health happens during the journey.
Who has chronic pulmonary edema can travel by plane? It depends. Yes, there is the possibility that a person with pulmonary edema can ride a plane without facing any major problems. However, only a doctor who knows the patient’s history can authorize the trip.
In addition to talking to a health professional, the person with pulmonary edema also needs to report his condition to the airline, which can request a medical report to assess the situation or even prepare the crew to serve the patient in the best possible way during the flight.
Can children have pulmonary edema? Yes, children and babies can have pulmonary edema.
In most cases, pulmonary edema in children is related to congenital heart disease, post-surgical complications or accidents (such as drowning and fires, for example). However, all causes of pulmonary edema in adults also apply to small children.
Pulmonary edema is a serious problem that requires express medical care, but with the right treatment, it can improve.
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