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Pulmonary Edema

Pulmonary Edema



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Published by Nader Smadi

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Published by: Nader Smadi on Feb 07, 2009
Copyright:Attribution Non-commercial


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Pulmonary Edema

Your lungs contain millions of small, elastic air sacs. With each breath, the air sacs
take in oxygen and release carbon dioxide. Normally, the exchange of gases takes
place without problems. But sometimes increased pressure in the blood vessels in
your lungs forces fluid into the air sacs, preventing them from absorbing oxygen \u2014 a

condition called pulmonary edema.

In most cases, heart problems cause pulmonary edema. But fluid can accumulate for other reasons, including pneumonia, exposure to certain toxins and medications, and exercising or living at high elevations.

Acute pulmonary edema is a medical emergency requiring immediate care. Although
pulmonary edema can sometimes prove fatal, the outlook is often good when you
receive prompt treatment for pulmonary edema along with therapy for the underlying

Depending on the cause, pulmonary edema symptoms may appear suddenly or
develop slowly over weeks or months.
Signs and symptoms that come on suddenly are usually severe and may include:
Extreme shortness of breath or difficulty breathing
A feeling of suffocating or drowning
Wheezing or gasping for breath
Anxiety, restlessness, a sense of apprehension
A cough that produces frothy sputum that may be tinged with blood
Excessive sweating
Pale skin
Chest pain when pulmonary edema is caused by coronary artery disease
If you develop any of these signs or symptoms, call 911 or emergency medical
assistance right away. Pulmonary edema can be fatal if not treated.
Signs and symptoms that develop more gradually include:
Difficulty breathing when you're lying flat as opposed to sitting up.
Awakening at night with a breathless feeling.
Having more shortness of breath than normal when you're physically active.

Significant weight gain when pulmonary edema develops as a result of
congestive heart failure, a condition in which your heart pumps too little blood
to meet your body's needs. The weight gain is from accumulation of fluid in
your body, especially in your legs.

Airways and air sacs of the lungs
Chambers and valves of the heart

Two major airways (bronchi) carry air into your lungs. These airways subdivide into smaller airways (bronchioles) that finally end in clusters of tiny air sacs called alveoli. These air sacs inflate like miniature balloons every time you inhale.

Wrapped around each air sac are capillaries that connect the arteries and veins in your
lungs. The capillaries are so narrow that red blood cells have to pass through them in
single file. Each red blood cell absorbs oxygen, while the plasma \u2014 the fluid
containing the red blood cells \u2014 releases carbon dioxide as well as absorbs some of
the oxygen.

But in certain circumstances, the alveoli fill with fluid instead of air, preventing
oxygen from being absorbed into your bloodstream. A number of factors can cause
fluid to accumulate in your lungs, but most have to do with your heart (cardiac
pulmonary edema). Understanding the relationship between your heart and lungs can
help explain why.

How your heart works

Your heart is composed of two upper and two lower chambers. The upper chambers (the right and left atria) receive incoming blood and pump it into the lower chambers. The lower chambers, the more muscular right and left ventricles, pump blood out of your heart. The heart valves \u2014 which keep blood flowing in the correct direction \u2014 are gates at the chamber openings.

Normally, deoxygenated blood from your body enters the right atrium and flows into
the right ventricle, where it's pumped through large blood vessels (pulmonary arteries)
to your lungs. There, the blood releases carbon dioxide and picks up oxygen. The
oxygen-rich blood then returns to the left atrium through the pulmonary veins, flows
through the mitral valve into the left ventricle, and finally leaves your heart through
another large artery, the aorta. The aortic valve at the base of the aorta keeps the blood
from flowing backward into your heart. From the aorta, the blood travels to the rest of
your body.

What goes wrong

Cardiac pulmonary edema \u2014 also known as congestive heart failure \u2014 occurs when
the left ventricle isn't able to pump out enough of the blood it receives from your
lungs. As a result, pressure increases inside the left atrium and then in the pulmonary
veins and capillaries, causing fluid to be pushed through the capillary walls into the
air sacs.

Congestive heart failure can also occur when the right ventricle is unable to overcome
increased pressure in the pulmonary artery, which usually results from left heart
failure, chronic lung disease or high blood pressure in the pulmonary artery

(pulmonary hypertension).
Medical conditions that can cause the left ventricle to become weak and eventually
fail include:

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