Definition Pulmonary oedema is an abnormal buildup of fluid within the tissues of the lung.
What is going on in the body? Fluid can build up in the lungs for many reasons. This fluid makes it difficult for the lungs to give oxygen to the blood. The low oxygen in the blood and the fluid itself cause symptoms.
What are the signs and symptoms of the condition? Pulmonary oedema may cause:
shortness of breath, which usually gets worse with activity or when laying flat
coughing up frothy phlegm, which may contain some blood
A person may also have symptoms from the underlying cause of the pulmonary oedema.
What are the causes and risks of the condition? Pulmonary oedema has many causes, including:
heart problems, such as a weakened heart due to cardiomyopathy or heart attacks. An abnormal heart valve, such as occurs with chronic mitral regurgitation, may also cause this condition.
low protein levels in the body, such as from malnutrition or a kidney condition called nephrotic syndrome, in which protein is lost into the urine. Cirrhosis, or permanent hardening and scarring of the liver, can also cause low protein in the body.
exposure to certain toxins or medications, such as carbon monoxide poisoning or a severe aspirin overdose
severe allergic reactions, called anaphylaxis, which may occur in response to antibiotics such as penicillin and other medications
acute mountain sickness, which occurs when a person goes from a low altitude to a high altitude quickly
What can be done to prevent the condition? Many cases of pulmonary oedema are unavoidable. Persons with heart problems should take medications as prescribed. Narcotics should not be abused. Those who are mountain climbing should avoid going beyond 8,000 feet above sea level unless they are experienced or are with a guide.
How is the condition diagnosed? The history and physical examination usually make a doctor suspicious. A chest x-ray usually shows the extra fluid in the lungs. Further tests may be needed to figure out the cause of the lung oedema. These may include blood tests or further x-ray tests, such as a pulmonary ventilation scan and a pulmonary perfusion scan.
What are the long-term effects of the condition? Severe pulmonary oedema can lead to death. Most of the long-term effects are related to the cause of the pulmonary oedema. For example, those with severe heart disease may be unable to perform daily activities without getting tired or having shortness of breath. On the other hand, oedema from an infection that is successfully treated often causes no long-term effects.
What are the risks to others? Lung oedema is not contagious and does not pose any risk to others.
What are the treatments for the condition? A person with lung oedema is usually given oxygen. If the oedema is severe, the person may need to be put on a ventilator, or artificial breathing machine. Other treatments depend on the underlying cause. For example, diuretic medications, or "fluid pills," may be given to draw fluid out of the lungs. Antibiotics are given if a bacterial infection is the cause.
What are the side effects of the treatments? Persons who require a ventilator may rarely develop an infection or damage to the lungs from the machine. All medications have side effects. Diuretics may cause allergic reactions and salt imbalances. Antibiotics also may cause allergic reactions, stomach upset, and other side effects. Other side effects depend on the medications used.
What happens after treatment for the condition? If the underlying cause of the pulmonary oedema is corrected, the person gets better and can return to normal activities. Lifelong treatment may be needed to prevent future episodes of pulmonary oedema, such as in a person with a weakened heart.
How is the condition monitored? Symptoms are monitored and follow-up physical examinations are needed. Blood tests, the amount of urine produced, and chest x-rays may also be used for monitoring.
Author: Adam Brochert, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
