Pulmonary Edema – Symptoms and Causes

ByJanis Updated

Pulmonary edema happens when too much fluid builds up in the lungs, filling the air sacs and making breathing difficult.

While heart problems are the most common cause, other factors can also lead to this condition. These include pneumonia, exposure to certain toxins, some medications, chest injuries, and high-altitude activities.

When pulmonary edema comes on suddenly, it’s considered a medical emergency that requires immediate medical attention. Without prompt treatment, this condition can be life-threatening.

Warning Signs

Sudden lung fluid buildup can cause serious symptoms that need immediate medical attention:

  • Severe breathing trouble that gets worse during activity or when lying down
  • Feeling of drowning or suffocating that worsens in a flat position
  • Cough with frothy, possibly blood-tinged fluid
  • Fast, irregular heartbeat
  • Intense anxiety or sense of impending danger
  • Cool, damp skin
  • Wheezing sounds when breathing

Ongoing Lung Fluid Signs

People with chronic lung fluid may experience:

  • Nighttime awakening feeling breathless, often improved by sitting up
  • Trouble breathing during activities or when lying flat
  • Unusual tiredness
  • Increased shortness of breath during normal activities
  • New or worsening cough
  • Rapid weight increase
  • Puffy legs and feet
  • Wheezing when breathing

Mountain Sickness Lung Fluid Symptoms

This condition affects people visiting or exercising at high elevations. Watch for:

  • Headache (often the first sign)
  • Breathing difficulty that starts during activity but worsens even at rest
  • Decreased exercise ability
  • Dry cough initially
  • Cough producing pink-tinged or bloody, frothy fluid later
  • Very rapid heart rate
  • Unusual weakness
  • Pain in the chest area
  • Mild fever

Symptoms typically worsen during nighttime hours.

When to Get Emergency Help

Sudden fluid buildup in your lungs (acute pulmonary edema) requires immediate medical attention. Don’t wait to seek help if you notice these warning signs:

  • Sudden difficulty breathing
  • Feeling like you’re suffocating or gasping for air
  • Wheezing or bubbling sounds when breathing
  • Coughing up pink or bloody phlegm
  • Heavy sweating while struggling to breathe
  • Bluish or grayish skin color
  • Mental confusion
  • Severe drop in blood pressure causing dizziness or weakness
  • Worsening of existing symptoms

These symptoms signal a life-threatening emergency. Call 911 immediately rather than driving yourself to the hospital. While waiting for emergency services, try to remain calm and sit upright to ease breathing if possible.

Causes

The lungs are essential organs for breathing. They contain millions of tiny air sacs called alveoli.

These small sacs have a crucial job – they take in oxygen when you breathe in and release carbon dioxide when you breathe out. This gas exchange normally happens smoothly.

The alveoli have very thin walls that allow oxygen to pass into nearby blood vessels and carbon dioxide to exit from the bloodstream. When these air sacs work properly, you breathe easily, and your body gets the oxygen it needs.

How Your Heart Functions

Your heart works as a pump that moves blood throughout your body. It beats about 100,000 times daily, pushing blood through a network of blood vessels. This constant pumping delivers oxygen and nutrients to all parts of your body.

Blood circulates through your heart in a specific pattern. First, oxygen-poor blood enters the right side of your heart. The heart then pumps this blood to your lungs, where it picks up oxygen and releases carbon dioxide.

The oxygen-rich blood returns to the left side of your heart, which pumps it out to the rest of your body.

Heart Chambers and Valves

The heart contains four chambers—two upper chambers (atria) and two lower chambers (ventricles).

The right atrium receives oxygen-poor blood from the body and sends it to the right ventricle. The right ventricle pumps this blood to the lungs.

After picking up oxygen in the lungs, blood flows into the left atrium and then to the left ventricle. The left ventricle is the strongest chamber, pumping oxygen-rich blood through the aorta to the entire body.

Four valves control blood flow through the heart:

  • Tricuspid Valve: Between the right atrium and right ventricle.
  • Pulmonary Valve: Between the right ventricle and the pulmonary artery.
  • Mitral Valve: Between the left atrium and the left ventricle.
  • Aortic Valve: Between the left ventricle and the aorta.

These valves ensure blood flows in the correct direction and prevent backward flow.

Heart-Related Fluid Buildup in Lungs

When pulmonary edema stems from heart problems, doctors call it cardiogenic pulmonary edema. This happens most commonly with heart failure – when the heart can’t pump blood effectively.

The left ventricle plays a crucial role. When it weakens or becomes damaged, it struggles to pump out all the blood it receives. This creates a backup of pressure that forces fluid through blood vessel walls into the lung air sacs.

Several heart conditions can lead to this type of pulmonary edema:

  • Clogged Arteries: Fatty deposits can narrow coronary arteries, weakening the heart muscle. A blood clot in these narrowed vessels can cause a heart attack, further damaging the heart’s pumping ability.

  • Heart Muscle Damage: Various conditions can harm the heart muscle directly. When damaged, the heart works harder, pressure increases, and fluid can back up into the lungs.

  • Valve Problems: Heart valves that don’t open properly (stenosis) or close properly (regurgitation) disrupt normal blood flow and can lead to fluid buildup in the lungs.

  • High Blood Pressure: Without proper treatment, high blood pressure forces the heart to work harder and can enlarge it over time.

  • Other Heart Issues: Inflammation of heart muscle, birth defects, or irregular heartbeats can contribute to pulmonary edema.

  • Kidney Disease: Kidney problems can cause fluid retention and increase blood pressure, potentially leading to pulmonary edema.

Non-Heart-Related Fluid Buildup in Lungs

Not all cases of pulmonary edema come from heart problems. When the cause isn’t related to heart function, it’s called noncardiogenic pulmonary edema. This type can develop from:

  • Acute Respiratory Distress Syndrome (ARDS): A serious condition where lungs suddenly fill with fluid after severe injury, infection, or pneumonia.

  • Medication Reactions: Both prescription drugs and illegal substances can trigger pulmonary edema in some people.

  • Blood Clots in Lungs: A clot that travels from leg veins to the lungs can cause fluid buildup.

  • Toxin Exposure: Inhaling harmful chemicals or accidentally breathing in stomach contents when vomiting can damage lung tissue.

  • Viral Infections: Certain viruses can attack lung tissue and cause fluid accumulation.

  • Drowning Incidents: Water inhalation damages the lungs and causes them to fill with fluid.

  • Airway Blockage: When something blocks the upper airway, trying to breathe creates negative pressure that pulls fluid into the lungs.

  • Brain Injuries: Head trauma, seizures, or brain surgery can trigger a type of pulmonary edema called neurogenic pulmonary edema.

  • Blood Transfusions: Some people develop pulmonary edema after receiving blood products.

  • Smoke Inhalation: Chemicals in smoke damage the barrier between air sacs and blood vessels, allowing fluid leakage.

High-Altitude Pulmonary Edema

People who travel to high elevations, typically above 8,000 feet (2,400 meters), may develop high-altitude pulmonary edema (HAPE). This dangerous condition occurs when the blood vessels in the lungs constrict due to low oxygen levels.

This constriction creates increased pressure in the lung blood vessels. The higher pressure forces fluid from the bloodstream into lung tissues and eventually into the air sacs. When this happens, oxygen can’t enter the bloodstream properly.

HAPE typically affects people who:

  • Ascend too quickly to high elevations
  • Don’t take time to acclimatize properly
  • Have had HAPE previously
  • Have certain genetic factors that increase susceptibility

Even people who live at high altitudes can develop HAPE if they get a respiratory infection or illness that affects their breathing.

Risk Factors

Several conditions can increase the chance of developing pulmonary edema. Heart problems that raise pressure within the heart are major risk factors, including:

  • Irregular heartbeats
  • Heavy alcohol consumption
  • Heart defects present at birth
  • Narrowed heart arteries
  • Diabetes
  • Damaged heart valves
  • High blood pressure
  • Sleep apnea

The risk also rises with certain nervous system problems and lung damage from:

  • Near-drowning incidents
  • Drug use
  • Smoke inhalation
  • Viral infections
  • Blood clots in lungs

This condition typically affects those who don’t allow their bodies enough time—several days to a week—to adjust to higher elevations. Children with existing pulmonary high blood pressure and structural heart abnormalities may have a higher risk for high-altitude pulmonary edema.

Health Problems

Pulmonary edema can lead to several health issues if not treated quickly. When fluid keeps building up in the lungs, it can cause high blood pressure in the pulmonary artery.

This puts extra strain on the heart, making it weaker over time.

People with pulmonary edema might have trouble breathing, which affects their daily activities. Swelling often appears in the legs, feet, and stomach area as the condition worsens.

Other complications include:

  • Fluid collecting around the lungs (pleural effusion)
  • Liver swelling and congestion

These problems can become life-threatening if not addressed immediately. That’s why quick medical help is essential for anyone showing signs of acute pulmonary edema.

Treatment Options

Treatment approaches depend on what’s causing the fluid buildup. Most patients receive supplemental oxygen therapy to help them breathe more easily.

Doctors also prescribe various medications to remove excess fluid, improve heart function, or address underlying infections. For severe cases, hospital care may include advanced breathing support.

How to Avoid Lung Problems at High Altitudes

You can take steps to prevent lung problems by managing any heart or lung conditions you already have.

A healthy lifestyle also helps lower your risk.

To keep your heart healthy, try these tips:

  • Eat foods rich in fruits, vegetables, whole grains, and low-fat proteins
  • Don’t use tobacco products
  • Exercise regularly
  • Reduce salt and alcohol intake
  • Find healthy ways to manage stress
  • Maintain a healthy weight

When climbing to high elevations, your body needs time to adjust to less oxygen in the air. Climb slowly, increasing your elevation by no more than 1,000 feet (300 meters) per day once you reach 8,200 feet (2,500 meters).

Some medications can help prevent problems at high altitudes.

Talk to your doctor about:

  • Acetazolamide
  • Nifedipine

Start taking these medications at least one day before you begin climbing. Your doctor can tell you how long to continue taking them after you reach your destination.


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Health Writer

Janis's areas of expertise include nutrition, exercise, stress management, and mental health. She is passionate about educating and empowering people to take control of their health and make positive changes that can last a lifetime. Janis believes that small, sustainable changes are the key to long-term success, and she works with her clients to develop personalized plans that fit their individual needs and lifestyles.