Alternate Names: Lung water; Severe heart failure

Causes and Risks: Pulmonary edema is a complication of a myocardial infarction (heart attack), mitral or aortic valve disease, cardiomyopathy (disease of the heart muscle) exposure to high altitude (rare), or other disorders characterized by cardiac dysfunction. Fluid overload is a common cause in infants.

Fluid backs up into the veins of the lungs. Increased pressure in these veins forces fluid out of the vein and into the air spaces (alveoli). This interferes with the exchange of oxygen and carbon dioxide in the alveoli.

Prevention: In many cases, this condition can not be prevented. The risk can be reduced by prompt treatment of cardiac disorders.

Symptoms:

• Extreme shortness of breath, severe difficult breathing
• Feeling of "air hunger" or "drowning"
• "Grunting" sounds with breathing
• Inability to lie down
• Rales
• Wheezing
• Anxiety
• Restlessness
• Cough
• Excessive sweating
• Pale skin

• Nasal flaring
• Coughing up blood
• Breathing, absent temporarily

Signs and Tests: Listening to the chest with a stethoscope (auscultation) may show crackles in the lungs or abnormal heart sounds.

• A chest X-ray may show fluid in the lung space.
• An echocardiogram may be performed in addition to (or instead of) a chest X-ray.

Treatment: This is a medical emergency! Do not delay treatment. Hospitalization and immediate treatment are required.

Oxygen is given, by a mask or through a tube in the windpipe (endotracheal tube) using mechanical ventilation.

Medications include diuretics such as furosemide to remove fluid, vasodilators to help the heart pump better, drugs to treat anxiety, and other medications to treat the underlying cardiac disorder.

Prognosis: Pulmonary edema is a life-threatening condition. It is often curable with urgent treatment and subsequent control of the underlying disorder.

Complications: This is a life-threatening disorder.

Go to the emergency room or call the local emergency number (such as 911) if symptoms indicate pulmonary edema!