Acute Pulmonary Edema Is Always An Emergency

May 2021


Pulmonary edema is a problem because it causes the lungs to fill up with fluid. If enough fluid accumulates in the lungs, it can be very difficult for a person to breath.


If you have pulmonary edema, your doctor will monitor your heart rate, breathing, and oxygen levels. They may also order an echocardiogram or chest x-ray to better diagnose the cause of the condition and determine how best to treat it.


In the United States, approximately 2,900 cases of pulmonary edema are diagnosed each year. About 30% of these people have heart failure at the time of diagnosis. It is most commonly seen in older adults.


What Is Pulmonary Edema?


Pulmonary edema is when a build-up of fluid causes your lungs to fill up with liquid instead of air. It can be a complication of heart failure, in which case it's called cardiogenic pulmonary edema. It can also be caused by other things, including fluid buildup due to certain medications or an increase in capillary permeability.


What are the symptoms?


Symptoms can include shortness of breath, which may be worse when you lie down and may come and go a bit during the day. Symptoms may also include cough, chest pain, and fatigue. As mentioned above, if it is caused by heart failure you might have swelling in your ankles or legs as well as fluid retention and weight gain around your neck.


How is it diagnosed?


A doctor will suspect pulmonary edema if you have heart failure. A chest x-ray will reveal enlarged lungs and fluid in the chest cavity. An echocardiogram can also show which organs are working and how much fluid they're moving. A heart-healthy diet may be helpful for those with chronic heart failure, so your doctor may also recommend that you drink more water or take diuretics or ACE inhibitors to help get rid of excess fluid.


There are a number of tests that are used to detect pulmonary edema. The most important tests include:



  • Chest X-rays and CT scans can detect fluid buildup in the lungs. However, CT scans use radiation and should not be performed on pregnant women unless necessary.

  • Cardiac catheterization involves inserting a tube into an artery or vein in the chest to take samples of fluid and pressure measurements. This procedure should only be used for diagnosing heart disease or pulmonary edema prior to surgery.

  • Lungs may also be filled with air to see if there is any leakage around the blood vessels, which could suggest pulmonary edema.


Although PE can be treated using a variety of different therapies, it often remains fatal if left untreated. Various targeted and/or non-targeted therapeutics are being developed by several pharmaceutical companies in an attempt to treat PE in various patient populations. These include small molecules as well as CAR-T and Exosome-based therapies.


In recent years, the mortality rate for PE has remained relatively stable while the number of patients receiving treatment has increased tremendously. The efficiency of current therapies for treating PE has been low; this may be because existing drugs have poorly defined mechanisms of action or simply do not work as expected.

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