Lung/pulmonary congestion

Alternative names

Pulmonary edema; Lung water

Definition

Pulmonary edema involves fluid accumulation and swelling in the lungs.

Causes, incidence, and risk factors

Pulmonary edema is usually caused by heart failure that results in increased pressure in the pulmonary (lung) veins. However, problems within the lungs themselves can also result in fluid accumulation.

Pulmonary edema can be a complication of a heart attack, leaking or narrowed heart valves (mitral or aortic valves), or any disease of the heart that either results in weakening and/or stiffening of the heart muscle (cardiomyopathy). The failing heart transmits its increased pressure to the lung veins. As pressure in the lung veins rises, fluid is pushed into the air spaces (alveoli). This fluid then becomes a barrier to normal oxygen exchange, resulting in shortness of breath.

Pulmonary edema can also be caused by direct lung injury from toxins including heat and poisonous gas, severe infection, or an excess of body fluid as seen in kidney failure.

Symptoms

• Shortness of breath
  
• Difficulty breathing
  
• Feeling of "air hunger" or "drowning"
  
• Grunting or gurgling sounds with breathing
  
• Wheezing
  
• Shortness of breath with lying down, causing the patient to sleep with head propped up or using extra pillows
  
• Cough
  
• Anxiety
  
• Restlessness
  
• Excessive sweating
  
• Pale skin
  

Additional symptoms that may be associated with this disease:

• Nasal flaring
  
• Coughing up blood
  
• Inability to speak from air hunger
  
• Decrease in level of awareness
  

Signs and tests

During a physical exam, the provider may identify the following signs:

• Rapid breathing and increased heart rate
  
• Crackles in the lungs or abnormal heart sounds (while listening to the chest with a stethoscope)
  
• Pale or blue skin color
  

Possible tests include: