Pulmonary edema

A Pulmonary edema is a special form of edema. By edema I mean a pathological accumulation of water in the tissue. In the case of pulmonary edema, there is therefore more fluid in the lung tissue or in the lungs directly. This disease is usually caused by other diseases, such as heart failure (heart failure) or various kidney diseases. Pulmonary edema should be examined and treated by a doctor as soon as possible, otherwise serious complications can occur.

What is pulmonary edema?

Acute pulmonary edema occurs suddenly; among other symptoms, those affected suffer from feelings of suffocation and sweating and should be treated immediately in hospital.
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A Pulmonary edema is characterized by an accumulation of water in the lung tissue and in the alveoli, which can have various causes. These include heart failure and kidney disease, but also allergies and altitude sickness.

Pulmonary edema is a serious condition that needs medical attention. Pulmonary edema can occur acutely or develop chronically, i.e. slowly and unnoticed at first.

In the case of pulmonary edema, water first collects in the tissue between the lungs and progressively spreads to the alveoli, which are called alveoli. As a result, in the case of pulmonary edema, the lungs can no longer be adequately ventilated, as a result of which gas exchange and blood flow are impaired in the case of pulmonary edema.

causes

The causes of a Pulmonary edema are in most cases in a heart failure or heart failure or in kidney diseases that impair kidney function or other diseases. A distinction is therefore made between cardiogenic pulmonary edema and non-cardiogenic pulmonary edema.

When a heart can no longer work properly, the blood flows into the left ventricle of the heart without the heart being able to pump it back into the bloodstream. As a result, the pressure in the pulmonary veins increases. If there is a pressure of more than 25 mmHG, it is a matter of severe impairment of lung function. Water is pressed from the pulmonary capillaries into the surrounding tissue and causes pulmonary edema.

Non-cardiogenic diseases can be caused by allergies, malnutrition and liver and kidney diseases and altitude sickness are also possible causes of pulmonary edema.

In general, the causes of pulmonary edema lie in a disturbance in the pressure conditions, i.e. between oncotic and hydrostatic pressure within the lungs.

Symptoms, ailments & signs

The symptoms of pulmonary edema depend on the causes that led to the edema and the stage of the disease. In heart disease with fluid retention in the lungs, the main symptoms are cough and shortness of breath. A frothy or bloody sputum can also appear as an accompanying symptom of the cough.

Further symptoms are accelerated breathing, shortness of breath during physical exertion or at rest. The skin can look pale, anxiety and restlessness can occur, the chest hurts, palpitations and arrhythmias can occur, blood pressure can be high or low. In severe cases of pulmonary edema, a distinct rattle can be heard.

Acute pulmonary edema occurs suddenly; in addition to the other symptoms, those affected suffer from feelings of suffocation and sweating and should be treated immediately in hospital. Pulmonary edema due to a weak heart muscle usually develops rather insidiously and the symptoms slowly increase. They are similar to those of acute pulmonary edema, but there is also fluid retention, especially in the legs, which leads to weight gain.

Most of the time, those affected find it harder to breathe when lying down and wake up during the night because of shortness of breath, which improves when they straighten their upper body. In general, there may be physical weakness and decreased appetite.

Course of disease

Infogram about the different lung diseases and their characteristics, anatomy and location. Click to enlarge.

When the disease progresses one Pulmonary edema The hydrostatic pressure is understood to mean the pressure of the blood in the capillaries of the body. The protein components in the blood are responsible for the oncotic pressure. If the hydrostatic pressure in the capillary vessels rises or the oncotic pressure falls, water escapes from these capillary vessels into the surrounding tissue.

In the lungs, it accumulates in the lung tissue or in the alveoli. If this process continues, up to two liters of water can accumulate, which drastically affects lung function and is referred to as pulmonary edema. If pulmonary edema is present, the general condition will gradually or acutely worsen and breathing problems must lead to a doctor's consultation so that immediate treatment can be initiated.

The underlying diseases for pulmonary edema hardly resolve on their own and must be treated in intensive care. If pulmonary edema is not treated, pneumonia can occur as a complication. In general, life is at risk with pulmonary edema, especially if heart failure is the cause.

Complications

Pulmonary edema is a very serious disease that must definitely be treated by a doctor. Without treatment, the patient usually dies. The life expectancy of the person affected is also considerably restricted and reduced by the pulmonary edema. The further course of the disease, however, depends heavily on the cause of this complaint.

The patients suffer primarily from inner restlessness and shortness of breath. This also leads to tiredness and fatigue. Those affected can no longer perform physically difficult activities and suffer from reduced resilience. Furthermore, there is a cough and a racing heart. In the worst case, the affected person loses consciousness or suffers cardiac death.

Furthermore, if untreated, pulmonary edema leads to pneumonia, which can be just as fatal for those affected. The treatment of this disease is causal. In many cases, surgical interventions are necessary. The further course of the disease and the chances of success, however, depend heavily on the cause of this complaint. In many cases, pulmonary edema reduces the patient's life expectancy.

When should you go to the doctor?

Pulmonary edema is a life-threatening clinical picture that must be treated by a doctor. The symptoms are usually so severe that treatment is essential and unavoidable. In particularly severe cases, artificial respiration is required, as breathing is very difficult with pulmonary edema. If you leave this clinical picture completely without medical care, you are putting yourself at great risk. An accumulation of water in the lungs is life-threatening and can also cause permanent consequential damage. For this reason, a visit to the doctor should not be put off.

Complete recovery can only be achieved with appropriate treatment. The following applies: Pulmonary edema is a clinical picture that absolutely requires appropriate treatment. Those who refrain from taking appropriate medication are putting their lives in danger. In particularly acute cases, inpatient treatment is even required in order to ensure that the treatment runs smoothly. Even with immediate medical care, permanent damage can occur that can no longer be treated or removed afterwards.

Treatment & Therapy

Coughing, faster breathing, and a faster heartbeat are signs of pulmonary edema. To diagnose, the lungs must be monitored and then x-rays and possibly also a computed tomography are made. Blood tests and cardiac exams as well as ultrasound examinations complement the diagnostic procedures.

Then intensive therapy is initiated. Oxygen can be supplied through nasal tubes, the upper body is elevated and medication must be taken. Depending on the cause, the body needs to be detoxified or treated for functional diseases. Dialysis may be started if you have kidney disease. Pulmonary edema must always be treated in intensive care.

Aftercare

Without medical treatment, pulmonary edema leads to pneumonia, which is why regular follow-up care is essential. This can also be fatal for those affected. In many cases, surgery is required to treat the disease. However, the course of the disease and the chances of successful treatment depend on the cause of its occurrence. Accordingly, general restraint and avoidance of excessive physical strain are recommended. In addition, people with lung disease should breathe sea air if possible; a visit to a salt grotto can promise relief and promote the healing process.

Due to the reduced resilience, those affected are hardly resilient and always rely on the help and support of relatives.Everyday tasks can no longer be carried out independently, which can sometimes lead to annoyance. A corresponding sensitization of relatives and friends can help to better understand how to deal with the disease and improve cooperation.

Outlook & forecast

Pulmonary edema develops because of an existing medical condition. The accumulation of water in the tissue of the lungs is therefore a symptomatic phenomenon and not an independent disease. For this reason, the prognosis is based on the overall assessment of the patient's health. Basically, it is an intensive care emergency.

If the cause of the accumulation of water can be traced back to an allergic reaction, avoidance of the triggering stimulus can often relieve symptoms. People who suffer from altitude sickness should also avoid staying in high altitude areas so that recovery can occur permanently. A cure is not possible in either case.

The freedom from complaints is automatically set if the trigger is avoided. If the pulmonary edema is the result of an organic disease, the overall prognosis is worse. Functional disorders of the kidneys and the heart are chronic or permanent in a large number of patients. Without medical care, the symptoms cannot be relieved.

Instead, an increase in health irregularities can be expected. In the worst case, the affected person dies prematurely. Treatment of the organ disorder is associated with various risks and side effects. However, it is currently the only way to improve it.

You can do that yourself

If pulmonary edema is found, medical treatment is usually given immediately. Medical treatment can be supported by a few measures.

First of all, it is advisable to adhere to the doctor's instructions and, above all, to take the prescribed medication reliably in order to avoid complications. There is an increased risk of acute pulmonary edema when hiking in the mountains. If symptoms such as insomnia, shortness of breath, fluid accumulation in the limbs or headaches arise at an altitude of over 2,400 meters, you must descend immediately. Then see a doctor. If the edema is caused by a heart disease, regular weighing is indicated. In this way, any weight gain caused by any edema can be determined and clarified by a doctor. The doctor will also recommend a low-salt diet.

The person concerned should also seek advice from a nutritionist and generally pay attention to a healthy lifestyle. A balanced diet, regular, moderate exercise and the avoidance of stress can reduce the risk of many of the underlying diseases. Patients who have ever suffered from pulmonary edema should regularly consult a cardiologist or pulmonologist. The family doctor can also determine edema and initiate suitable therapy.