PULMONARY EDEMA

General Information

DEFINITION--A set of dramatic, life-threatening symptoms caused by congestive heart failure.

BODY PARTS INVOLVED--Lungs and heart.

SEX OR AGE MOST AFFECTED--Adults over 40.

SIGNS & SYMPTOMS--

The following symptoms often begin suddenly in the middle of the night and worsen rapidly:

• Extreme shortness of breath, sometimes with wheezing.
• Rapid breathing.
• Restlessness and anxiety.
• Paleness.
• Sweating.
• Bluish nails and lips.
• Low blood pressure.
• Cough. This may be unproductive at first, but later it can produce a frothy, blood-stained sputum.

CAUSES--Failure of the heart's left ventricle to pump well enough to supply all body cells with oxygen. The underlying cause of heart failure includes many forms of heart disease, especially heart-rhythm disturbances or hypertension with atherosclerosis or narrowing of the aortic valve.

RISK INCREASES WITH

• Adults over 60.
• Stress.
• Recent heart attack.
• High blood pressure or any form of heart disease.
• Obesity.
• Smoking.
• Fatigue or overwork.

HOW TO PREVENT--If you have any form of heart disease, obtain prompt treatment for less dramatic signs of congestive heart failure. The treatment may include a low-salt diet, smoking cessation, maintenance of an ideal weight, adequate rest and prescription drugs.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies and ECG (See Glossary), chest x-ray, pulmonary function studies and pulmonary arterial catheterization (a study to evaluate function of the heart).

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Treatment is designed to reduce the excess fluid, improve lung and heart function and correct any underlying disorder.

POSSIBLE COMPLICATIONS

• Death (if treatment is delayed or unsuccessful).
• Misdiagnosis as asthma, resulting in inappropriate treatment.

PROBABLE OUTCOME--In most cases, symptoms can be controlled with treatment. The treatment for pulmonary edema usually brings dramatic and effective relief. However, the underlying heart disease causing pulmonary edema will require lifelong treatment.

How To Treat

GENERAL MEASURES----Self-care is not appropriate for pulmonary edema. This is a medical emergency requiring intensive medical care. Delay can lead to death.

MEDICATION--Your doctor may prescribe:

• Narcotics to relieve anxiety, decrease blood flow to the lung and reduce oxygen demand of the body.
• Diuretics to decrease excess fluid circulating in the bloodstream and lessen fluid accumulated in the lungs.
• Digitalis to stimulate a stronger heartbeat.
• Antibiotics (if pulmonary edema has been triggered by infection).
• Medications such as beta-blockers, ACE inhibitors, nitrates and calcium-channel blockers to reduce workload on the heart.
• Supplemental oxygen.

ACTIVITY--Rest in bed until your condition stabilizes. After treatment, resume your normal activities gradually. Resume sexual relations when symptoms disappear and strength returns.

DIET--Your doctor may recommend a low-salt, low-fat diet (see both in Appendix).

Call Your Doctor If

You have symptoms of pulmonary edema. This is an emergency!