Pulmonary edema

Introduction:

Pulmonary edema happens when increased pressure in the blood vessels in your lungs causes
them to fill up with fluid, making it hard to breathe. It is often caused by heart disease. It may
also be caused by acute severe asthma, pneumonia, or exercising at high altitudes. It can also
occur after a blood transfusion. Pulmonary edema is a serious condition requiring immediate
medical attention.

Signs and Symptoms:

Symptoms may begin suddenly and get worse quickly. They include:

 Extreme shortness of breath and difficulty breathing

 Tightness and pain in the chest
 Wheezing, coughing
 Paleness
 Sweating
 Bluish nails and lips
 Pink, frothy mucus coming from nose and mouth

If pulmonary edema is related to congestive heart failure, symptoms may come on more
gradually. You may notice shortness of breath when you' re lying down, quick weight gain (from
retaining fluid), and fatigue.

What Causes It?:

The most common cause of pulmonary edema is heart failure. But not every case is due to heart
problems. Some risk factors for pulmonary edema include:

 High blood pressure

 Diabetes
 Coronary or valvular heart disease
 Obesity
 Being at high altitude
 Central nervous system injury
 Infection
 Hanta virus
 Inhaling toxins

What to Expect at Your Provider's Office:

Pulmonary edema that happens suddenly is life threatening and requires immediate treatment.
Once the initial attack is under control, your health care provider will order blood tests and a
urine test to determine what caused the attack. Other tests may include a chest x-ray,
electrocardiogram, echocardiogram, transesophageal echocardiogram, or cardiac catheterization.
If you are in the hospital, you will be given oxygen.

Treatment Options:

Medications may include diuretics (water pills) to get rid of excess fluid in your lungs, blood
pressure medication, and drugs to dilate blood vessels. In rare cases, surgery may be needed.

Complementary and Alternative Therapies

Pulmonary edema should be treated with conventional medications. Complementary and
alternative therapies can be used along with conventional care, helping to strengthen your heart
and lungs. But they should never be used alone to treat pulmonary edema. Make sure to tell all of
your medical providers about any alternative therapies or supplements you may be using.

Nutrition and Supplements

Depending on what kind of diuretic you take, you may need to increase potassium and
magnesium in your diet (for example, by eating bananas, apricots, nuts, seeds, and green leafy
vegetables). With other kinds of diuretics, you may need to make sure you don' t get too much
potassium. Ask your doctor if you need more magnesium and potassium.

 Coenzyme Q10 (100 mg two times per day) is good for heart health. Several research
studies suggest that CoQ10 supplements can help reduce swelling in the legs, enhance
breathing by reducing fluid in the lungs, and increase exercise capacity in people with
heart failure. Not all studies agree, however. If you take blood-thinning medication
(anticoagulants), ask your doctor before taking CoQ10.
 L-carnitine (500 mg three times per day) improves endurance and is good for heart
health. Carnitine is a nutrient that helps the body convert fatty acids into energy, which is
then used primarily by your muscles. If you take blood-thinning medication
(anticoagulants) or thyroid hormone, ask your doctor before taking carnitine.
 Magnesium (200 mg two to three times per day) helps your heart work efficiently and
may help treat congestive heart failure. In addition, some diuretics (water pills) may
cause your body to lose too much magnesium. For this reason, your doctor may
recommend a supplement. Magnesium and calcium work together to help your heart
function, so it' s important to ask your doctor before taking either magnesium or calcium
supplements. Both interact with several medications, herbs, and supplements as well.
 Potassium helps heart muscle to contract. Depending on the type of diuretic you take,
your doctor may recommend taking a potassium supplement. The dose will depend on the
level of potassium in your blood, so your doctor will determine the proper amount.
However, with other kinds of diuretics taking a potassium supplement might cause you to
get too much potassium. Ask your doctor before taking extra potassium.
  Vitamin E (400 IU per day) and vitamin C (1,000 - 1,500 mg per day) are antioxidants
that may promote heart health, although evidence is mixed.
 Thiamin (vitamin B1, 200 mg per day) may improve cardiac function in people with
heart failure, although studies show mixed results. In addition, diuretics (water pills) can
cause your body to lose too much thiamine. Talk to your doctor about measuring your
level of vitamin B1 and whether you should take thiamine.
 L-arginine (6 g per day) and taurine (1,000 mg twice a day), which are amino acids, may
improve heart function in people with heart failure. Be sure to ask your doctor before
taking l-arginine, because it may interfere with other treatments and may not be right for
you.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy,
you should work with your health care provider to diagnose your problem before starting any
treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine
extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb
per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for
roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.

Ask your doctor before taking herbs for pulmonary edema.

For pulmonary edema that does not originate with the heart:

 Garlic (Allium sativum), 1,000 - 4,000 mg per day, helps you cough up mucus, may
slightly lower blood pressure, and stimulates your immune system. Garlic may increase
the risk of bleeding, especially if you take blood-thinning medication (anticoagulants). If
you take blood thinners such as warfarin (Coumadin), ask your doctor before taking
garlic.
 Rosemary (Rosmarinus officinalis), 1 cup tea three times per day. May help the body get
rid of excess fluid. To make tea, steep 1 - 2 g of rosemary leaves in one cup boiling
water. Strain and cool. Do not take rosemary if you take diuretics (water pills).
 Scotch broom (Cytisus scoparius). Drink 1 cup tea three times per day. To make tea,
steep 1 - 2 g of rosemary leaves in one cup boiling water, strain, and cool.
 Horse chestnut (Aesculus hippocastanum), 250 mg two times per day, standardized for
aescin content, may help the body get rid of excess fluid. Use only reputable brands that
have been professionally formulated. Crude preparations can contain a toxic compound.
Do not use if you have liver or kidney disease or take blood-thinning medication
(anticoagulants), and do not exceed recommended dosage.
 Horsetail (Equisetum arvense) is traditionally used as a diuretic to help the body get rid
of excess fluid. Your doctor should determine the dose. Do not take horsetail if you have
high blood pressure or heart disease, and take it only under the supervision of a doctor.

For pulmonary edema originating with the heart, especially heart failure, the following herbs
may help. It is important to get a diagnosis from your doctor concerning the type of heart
disease, so you will know which herbs may be right for your condition.
  Hawthorn (Crataegus monogyna), 240 - 600 mg per day. Hawthorn is used in many types
of heart disease. Several scientific studies suggest that hawthorn improves the heart' s
ability to pump blood in people with heart failure. It also significantly improved
symptoms (like reduced shortness of breath and fatigue) and helped people exercise
longer.
 Linden (Tilia cordata), 1 - 2 cups tea per day. May help the body get rid of excess fluid.
To make tea, steep 2 g in one cup boiling water. Strain and cool. Do not take linden if
you take diuretics (water pills).
 Asian ginseng (Panax ginseng), 200 - 600 mg per day, may act as a diuretic. Do not take
ginseng if you take diuretics (water pills).
 Forskohlin (Coleus forskohlii), 50 - 100 mg two to three times a day.
 Astragalus (Astragalus membranaceus) helps the body get rid of excess fluid. The dose
should be determined by your doctor. Do not take astragalus if you take diuretics (water
pills).
 Ginkgo (Ginkgo biloba), 120 - 240 mg in two or three divided doses per day, may help
improve circulation and heart function. Do not take ginkgo if you take blood-thinning
medication (anticoagulants) or have diabetes.

Homeopathy

Homeopathy may be useful as a supportive therapy.

Physical Medicine

Alternating hot and cold applications with hand or foot baths may help circulation. Alternate 3
minutes hot with 1 minute cold. Repeat three times to complete one set. Do two to three sets per
day.

Being active or exercising helps your body get rid of excess fluid. Ask your doctor about the
level of physical activity that would be safe and beneficial for you.

Castor oil pack. Apply oil directly to the chest, cover with a clean soft cloth and plastic wrap.
Place a heat source over the pack, and let sit for 30 - 60 minutes. Repeat four to six times per
week.

Acupuncture

Acupuncture may improve heart and lung function.

Massage

Massage can help increase circulation.

Following Up:
If you have congestive heart failure, you will need to work closely with your doctor to manage
your symptoms.

Special Considerations:

Pregnant women who are obese and have high blood pressure are at increased risk for pulmonary
edema. Patients with heart failure may have pulmonary complications, including sleep apnea,
pulmonary edema, and pleural effusions.

 Reviewed last on: 3/30/2010

 Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in
complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed
Healthcare Network.

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