Pulmonary edema is an abnormal accumulation of watery fluid in the lung’s air sacs. It may be caused by congestive heart failure, kidney failure, viral infections, lung illness or injury, smoke inhalation, near-drowning, adverse drug reactions, or exposure to high altitude. In heart-related pulmonary edema, when the heart’s left ventricle is not able to pump out enough of the blood it receives from the lungs, pressure increases in the left atrium, and then in the blood vessels of the lungs, causing fluid to be pushed into the lung’s air sacs. High blood pressure from heart disease or kidney disease may also lead to fluid buildup.
Symptoms may include difficulty breathing when lying down, a “drowning” feeling that may awaken one from sleep, grunting or wheezing when breathing, shortness of breath that causes difficulty speaking, restlessness or decreased alertness, leg swelling, pale skin, or excessive sweating.
A physical exam may indicate abnormal heart sounds, “crackling” sounds in the lungs, an increased heart rate or rapid breathing, and pale or blue skin tone (due to decreased oxygen). Chest x-rays, blood tests, an echocardiogram (to visualize the heart muscle), or an electrocardiogram (to identify issues with heart rhythm or other indicators of a heart attack) may help diagnose pulmonary edema.
Pulmonary edema often requires treatment in a hospital or emergency room setting. Oxygen is administered and a tube may be placed into the trachea to connect a patient to a ventilator to assist breathing. Medications, such as diuretics to remove excess fluids from the body, or heart medicines that control the heartbeat or relieve pressure on the heart, may relieve symptoms.
The American Lung Association has helpful information about pulmonary edema as well as other pulmonary vascular diseases.