Understanding Pulmonary Oedema

Pulmonary oedema is marked by the buildup of excess fluid in the lungs’ air sacs (alveoli), which causes breathing difficulties. This fluid accumulation can make it difficult for oxygen to travel from the lungs into the bloodstream. This is a life-threatening condition and should be treated promptly.

High altitude pulmonary oedema (HAPE)is a serious altitude sickness that happens at high altitudes or during quick ascents in such areas because these places have lower oxygen levels. Decreased oxygen intake at high altitudes causes blood vessels to narrow within the lungs, which leads to excess fluid buildup. HAPE is a medical emergency and can endanger one's life.

Differentiating pulmonary oedema from other similar conditions

• Pleural effusion: Fluid accumulation in the lungs is involved in both pulmonary oedema and pleural effusion. However, the difference between pulmonary oedema is the accumulation of excess fluid in the tissues and air sacs in the lungs, while the fluid accumulation in pleural effusion happens within the pleural cavity which encloses the lung.

• Pneumonia: Fluid buildup in the lungs is present within both pulmonary oedema and pneumonia. However, pneumonia happens because of an infection, and it can be viral, bacterial, or fungal to begin with. An infection does not cause pulmonary oedema, and the fluid is usually thinner and more diluted.

• Pulmonary embolism: A pulmonary embolism occurs when a blood clot, typically originating from a vein in the leg, travels to the lungs through the bloodstream and becomes lodged in the lung’s vascular network. Pulmonary embolism can be lethal and swift medical intervention is needed.

Symptoms of pulmonary oedema

Pulmonary oedema can happen abruptly (acute) or progress gradually over time (chronic). The symptoms of acute pulmonary oedema include shortness of breath, particularly noticeable when lying down or moving, coughing up blood and/or frothy mucus, wheezing, chest pain or tightness, and feeling suffocated. 

Chronic pulmonary oedema symptoms are identical to acute pulmonary oedema but are usually milder than an acute attack. People with chronic pulmonary oedema can go through episodes of breathlessness while sleeping, leading them to wake up and gasp for air. Some also experience swelling around their extremities.

Risk factors

Most cases of pulmonary oedema are usually linked to heart disease, especially among individuals who are not compliant with their treatment regime. Conditions that increase the risk for pulmonary oedema include heart failure, coronary artery disease, heart valve issues, irregular heartbeat (arrhythmia), high blood pressure, liver disease, kidney failure, and lung injury.

Diagnosing and treating pulmonary oedema

Diagnosis

Clinical evaluation, medical history, physical examination, and diagnostic tests are ways to diagnose pulmonary oedema.

1. Complete blood count.
2. Cardiac biomarkers for heart failure.
3. Blood oxygen levels.
4. Liver and kidney function tests.
5. Chest X-ray to search for fluid buildup in the lungs and the heart’s shape/size.
6. Echocardiogram (heart ultrasound) to detect abnormalities in the structure and/or the heart’s function.
7. Electrocardiogram (ECG) to detect any abnormalities in the heart’s electrical activity.
8. Cardiac catheterisation to search for blockages in the coronary arteries.

Treatment

The focus of pulmonary oedema treatment is to address its underlying cause, decreasing fluid accumulation in the lungs, and improving oxygenation. Common treatment options available to treat people with pulmonary oedema include:

Preventing pulmonary oedema

Take the following precautions to help prevent pulmonary oedema:

1. Adhere to the treatment plan, particularly for patients with heart disease.
2. Get medical attention if you experience difficulties in breathing.
3. Go for regular checkups as recommended by your doctor.
4. Maintain a healthy weight.
5. Low-salt diet.
6. Consult your physician before engaging in high-altitude activities such as mountain climbing.

Schedule an appointment at Gleneagles Hospitals

A dedicated and expert team of cardiologists at Gleneagles Hospitals is available for consultation to provide the best care and assistance.

Get in touch with us to book an appointment today if you have concerns or questions regarding pulmonary oedema. We assure you the best possible care tailored to your specific needs.