(ARDS), smoke inhalation, near drowning, and high
altitude can also cause pulmonary edema.
Pulmonary edema can be a life-threat-
ening condition and requires immedi-
ate medical evaluation and treatment.The accumulated fluid of pulmonary edema
limits air from entering the alveoli, affecting the
OXYGEN–CARBON DIOXIDE EXCHANGE. The conse-
quence is inadequate oxygen diffusion into the
BLOODwith resulting HYPOXIA.
Symptoms and Diagnostic PathThe symptoms of pulmonary edema tend to come
on quickly and include
- DYSPNEA(difficulty BREATHING), often severe or
worse when lying down - frothy HEMOPTYSIS(coughing up bloody SPUTUM)
- diaphoresis (profuse sweating or chills with
sweating) - HEADACHEor light-headedness
- COUGH
- Wheezing or gurgling sounds when breathing
Respiratory failure can rapidly develop. The
diagnostic path includes AUSCULTATION with a
stethoscope to listen to BREATH SOUNDS, which typi-
cally reveals rales (crackles). A chest X-RAYshows
the accumulated fluid. Arterial blood gases assess
the extent of hypoxia. Diagnostic procedures to
evaluate cardiovascular function include ELECTRO-
CARDIOGRAM (ECG), ECHOCARDIOGRAM, andCARDIAC
CATHETERIZATION if the doctor suspects CORONARY
ARTERY DISEASE(CAD) orMYOCARDIAL INFARCTION.
Treatment Options and OutlookTreatment begins with OXYGEN THERAPYto improve
oxygenation and, if the edema is from heart fail-
ure, usually diuretic medications to help pull the
excessive fluid into the circulation so the KIDNEYS
can pass it from the body. Additional treatment
targets the underlying cause of the pulmonary
edema, which may be cardiovascular or pul-
monary. High altitude pulmonary edema (HAPE)
requires prompt oxygen therapy with descent to a
lower altitude as soon as is feasible. Climbers
sometimes underestimate the seriousness of HAPE
until symptoms become overwhelming and life-
threatening. Any climber, regardless of high-alti-
tude acclimation and climbing experience, is
vulnerable to HAPE and all climbers should be
familiar with early symptoms.
Pulmonary edema is a serious circumstance that
can result in death when not promptly recognized
and treated. The underlying cause determines the
outcome. When the cause is cardiovascular, treat-
ment may include CORONARY ARTERY BYPASS GRAFT
(CABG) orANGIOPLASTYto improve the flow of blood
to the HEART. Medications may strengthen the heart
and stabilize HEART RATEin heart failure, improving
the heart’s ability to pump blood. With appropriate
treatment, many people recover completely from
pulmonary edema. When the cause is noncardio-
genic, such as due to severe infection or ARDS,
treatment targets reversing the underlying disease
and providing respiratory support until lung func-
tion returns to normal.Risk Factors and Preventive Measures
The primary risk factor for cardiogenic pulmonary
edema is cardiovascular disease. The most effec-
tive preventive measures are those that reduce the
risks for cardiovascular disease: No smoking,
maintain appropriate weight, exercise daily, and
eat nutritiously. It is also important to take med-
ications for diagnosed conditions such as HYPERTEN-
SION(high BLOOD PRESSURE) as prescribed.
See also ASCITES; ESOPHAGEAL VARICES; PULMONARY
HYPERTENSION.pulmonary embolism A BLOODclot that blocks
the flow of blood through the main pulmonary
ARTERY, the right or left pulmonary artery, or
branching arteries within the lobes and segments
of the LUNGS. Untreated pulmonary embolism can
cause respiratory distress or death; about 30,000
people die each year in the United States as a
result of pulmonary embolism.Pulmonary embolism is a life-threaten-
ing condition that requires emergency
medical care.Pulmonary embolism is a potential complica-
tion of blood clots that develop within the veins,224 The Pulmonary System