Pulmonary edema, or fluid buildup in the lungs, is commonly caused by heart problems such as heart abnormalities, heart failure, and heart attacks. Other causes include lung injuries, blood problems, environmental factors, and trauma to other parts of the body. Treatment is available if sought promptly.
The most common causes of pulmonary edema are related to heart problems, especially heart abnormalities, heart failure, and a heart attack, medically known as myocardial infarction. Artery blockage problems known as myocardial ischemia are also often included in this list. The heart and lungs are connected in several important ways, and when the heart isn’t working properly, it can affect the amount of blood pumped in and out of the lungs, which in turn can cause or worsen fluid buildup problems. However, these aren’t the only potential causes of edema; Lung injuries and concussions also top the list. Blood problems, including pancreatitis and bad reactions to transfusions, are also possible, as are environmental factors such as heavy air pollution or reduced oxygen levels, particularly at high altitudes. The condition is quite serious, but can usually be treated if treatment is sought promptly. Anyone who has difficulty breathing, vomits blood, or experiences periodic bursts of intense difficulty breathing should usually seek medical attention as soon as possible.
Understand edema in general
“Edema” is a medical term used to describe swelling caused by fluid buildup. Pulmonary edema is a condition in which fluid builds up within the lung tissue. This fluid is often blood, but it can also be water, lymph fluid, mucus, or a combination of some or all of these. The extent of pulmonary edema depends on the osmotic and hydrostatic forces within the pulmonary capillaries.
Heart abnormalities
The major cardiogenic, or heart-related, causes of pulmonary edema include a variety of cardiac abnormalities that result in increased pulmonary venous pressure. This increase shifts the delicate balance between the interstitial tissue and the pulmonary capillaries. When this happens, the hydrostatic pressure increases, promoting the collection of fluid in the capillaries and subsequently in the alveoli. Alveoli are tiny air sacs that easily fill with fluid, causing shortness of breath and coughing.
Conditions and heart failure
Heart conditions such as congestive heart failure, blockages and collapse of arteries, heart attack, and valve abnormalities can also be causes. These problems often result in left ventricular volume overload, which causes an imbalance when it comes to how much blood is pumped to the lungs and how well they are oxygenated.
When it comes specifically to the heart valves, some of the biggest causes of pulmonary edema include mitral valve stenosis, mitral valve regurgitation, and aortic regurgitation. Ventricular septal defects, which are holes within the heart muscle that separate the heart’s two lower chambers, can also be problematic.
Pulmonary injuries and trauma
Direct injury to the lungs is also a very common cause. A collapsing lung is an extreme example, but severe bruising or scarring can also cause blood and lung fluids to pool. Edema increases within the lungs due to protein leaking through the damaged capillary linings. The fluid follows the leaking proteins due to oncotic forces causing dysfunction of the surfactant-coated alveoli.
Pulmonary edema can also result from lung re-expansion after a collapsed lung. Some of the more common symptoms of injury-related edema include extreme bouts of shortness of breath, particularly when lying down, and a bluish paleness of the skin.
Environmental factors
Some lung injuries that cause pulmonary edema are due to elevated hydrostatic pressure. For example, high altitude pulmonary edema (HAPE) is an acute mountain illness that occurs when people ascend to high altitudes without proper acclimatization. Of all the causes of this condition, HAPE has the simplest treatment—people usually just need to go down to lower elevations to set things right.
Injuries can also be caused by pulmonary contusion, pneumonia, pulmonary embolism, and oxygen toxicity, which occur from breathing high concentrations of oxygen at high atmospheric pressures. Air pollution can also be a cause, particularly in children and particularly in places where air quality is usually bad to begin with.
Problems in other parts of the body
The hematogenous lesions that cause pulmonary edema include an assortment of diseases. These are usually serious conditions and can include sepsis, disseminated intravascular coagulation (DIC), and pancreatitis. Multiple transfusions with bad reactions can also lead to fluid and swelling, as well as trauma to other parts of the body that may seem unrelated. If the injury is severe enough, the problems can travel through the blood to many different places. Prolonged time on cardiopulmonary bypass during surgeries can also sometimes lead to pulmonary edema.
Increases in hydrostatic pressure that can lead to swelling are also commonly caused by increased intracerebral pressure in the brain, which is called neurogenic pulmonary edema. Some chemical causes of pulmonary edema include radiographic contrast allergy, salicylate poisoning, and inhaled toxins, such as occurs in smoke inhalation.
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