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Pulmonary edema
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Pulmonary edema

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ASTHMA & RESPIRATORY SYSTEM
Respiratory System

Pulmonary edema is a medical emergency and requires immediate care. Although it can sometimes prove fatal, the outlook is often good when you receive prompt treatment along with therapy for the underlying problem.

Your lungs contain millions of small, elastic air sacs called alveoli. With each breath, these air sacs take in oxygen and release carbon dioxide, a waste product of metabolism. Normally, the exchange of oxygen and carbon dioxide takes place without problems. But sometimes increased pressure in the blood vessels in your lungs forces fluid into the air sacs, filling your lungs with fluid and preventing them from absorbing oxygen - a condition called pulmonary edema.

Screening and diagnosis

Because pulmonary edema requires prompt treatment, initial diagnosis is on the basis of your symptoms and a physical exam. You may also have blood drawn — usually from an artery in your wrist — so that it can be checked for the amount of oxygen and carbon dioxide it contains (arterial blood gas concentrations).

Once your condition is more stable, your doctor will ask about your medical history, especially whether you've ever had cardiovascular or lung disease. You'll also likely have a chest X-ray, which can help support a diagnosis of pulmonary edema. And you may have further tests to determine why you developed fluid in your lungs. These tests may include:

  • Electrocardiography (ECG). This noninvasive test can reveal a wide range of information about your heart. During an ECG, patches attached to your skin receive electrical impulses from your heart. These are recorded in the form of waves on graph paper or a monitor. The wave patterns show your heart rate and rhythm, and whether areas of your heart show diminished blood flow.

  • Echocardiography (diagnostic cardiac ultrasound exam). Another safe and noninvasive test, echocardiography uses a wand-shaped device called a transducer to generate harmless, high-frequency sound waves that are reflected from the tissues of your heart. The sound waves are then sent to a machine that uses them to compose images of your heart on a monitor. The test can help diagnose a number of heart problems, including valve problems, abnormal motions of the ventricular walls, fluid around the heart (pericardial effusion) and congenital heart defects. It also accurately measures the amount of blood your left ventricle ejects with each heartbeat (ejection fraction, or EF). The ventricles don't empty all their blood with each beat, but in most cases the EF should be greater than 50 percent. When the left ventricle begins to fail, this number falls. Although a low EF often indicates a cardiac cause for pulmonary edema, it's possible to have cardiac pulmonary edema with a normal EF.

  • Transesophageal echocardiography (TEE). In a traditional cardiac ultrasound exam, the transducer remains outside your body on the chest wall. But in TEE, a soft, flexible tube with a special transducer tip is inserted through your mouth and into your esophagus — the passage leading to your stomach. This provides a clearer view of your heart and central pulmonary arteries than does traditional echocardiography. You'll be given a sedative to make you more comfortable and prevent gagging. You may have a mild sore throat for a few days after the procedure, and there's a slight risk of perforation or bleeding from the esophagus.

  • Cardiac catheterization. If other tests don't reveal the reason for your pulmonary edema, your doctor may suggest a procedure to measure the pressure in your lung capillaries (wedge pressure). During this test, a small, balloon-tipped catheter (Swan-Ganz catheter) is gently inserted into a pulmonary artery. The catheter has two openings connected to pressure transducers. The balloon is inflated and then deflated, giving pressure readings.

Complications

When not treated, acute pulmonary edema can be fatal. In some instances it may be fatal even if you receive treatment. The outcome depends in part on the condition of your heart and lungs before you developed edema and on the amount of fluid in your lungs. Drug-induced pulmonary edema is a frequent cause of death in people who abuse narcotics.

Pulmonary edema > 1 > 2 > 3 > 4

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
In no event will The DrEddyclinic.com be liable for any decision made or action taken in reliance upon the information provided through this web site.

 


 



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Last Modified : 03/15/08 01:59 AM