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Fluid in the Lungs

more about Fluid in the Lungs

Pulmonary Edema or Lung Water

  • Numerous disorders lead to the accumulation of fluid or edema in the lungs.
  • Lungs (there are two) are normally air-filled; their main function being to take oxygen from the atmosphere, exchange it with carbon dioxide, and transfer the fresh oxygen to the blood for transport to all the cells in the body.
  • The lungs are spongy (comprised of multiple small sacs known as alveoli) organs located in the chest behind the rib cage.  When fluid builds up in the alveoli, it interferes with the normal oxygen intake -- causing severe disturbances in body function.

  • Shortness of breath
  • Gasping for air
  • Shortness of breath with activity
  • Inability to sleep lying flat (need more than 2 pillows)
  • Wheezing sound with breathing
  • Wet gurgling sounds in the chest
  • Coughing a pinkish or blood-tinged frothy sputum
  • Weakness
  • Fatigue
  • Anxiety and restlessness
  • Pounding or Racing Heart rate
  • Chest pain or sudden shortness of breath at night waking the patient up
  • Breathing may completely stop for a few seconds during sleep
  • Swelling (fluid build up) in the feet and ankles
  • Fever and other symptoms may occur according to the specific etiology.

  • Heart disorders can cause fluid to back up in the blood vessels (veins) that carry blood away from the lungs to the heart. As a result of pressure build-up in these veins, excess fluid leaks out into the alveoli.
  • Heart disorders:
    1. Heart attack (death of heart muscle) or Myocardial Infarction
    2. Left-sided Heart Failure
    3. Valvular heart disease -- poorly-functioning doors between heart's 4 chambers
    4. Arrhythmias -- irregularities in heart rhythm
    5. Cardiomyopathy -- enlarged, balloon- like myocarditis (i.e., infection of heart muscle)
    6. Congenital (present at birth) heart diseases -- such as holes in the walls between heart chambers (i.e., atrial and Ventricular Septal Defects).
    7. Endocarditis -- infection of the valves
    8. High Blood Pressure
    9. Volume or fluid overload -- too much liquid intake by a person with diseased heart or kidneys.
    10. Thyroid disease (hypothyroid or hyperthyroid) 
    11. Beriberi (Vitamin B1 deficiency)
  • Others:
    1. Kidney (renal) failure
    2. Pneumonia -- infection of the lungs
    3. Pulmonary Embolism -- blockage of lung blood vessels due to air bubbles, fat, amniotic fluid (in newborns), or clotted blood
    4. Pancreatitis -- irritation, infection, or damage to the pancreas.
    5. Drug overdose -- heroin and others
    6. Shock
    7. Drowning
    8. High altitude sickness -- rapid climbing to heights (mountains) can cause Pulmonary Edema and other problems.

  • History:
    1. Symptoms
    2. Illnesses
    3. Medications
    4. Surgeries
    5. Habits
    6. Family history
    7. Birth history
    8. Allergies
    9. Travel history
  • Medical exam:
    1. Patient will appear breathless with nasal flaring (sides of nose moving outward with each breath)
    2. The pulse rate (heart rate) may be faster than normal (60-100 beats per minute)
    3. The doctor, using a stethoscope, will hear the fluid in the lungs (rales and crepitations) and abnormal or extra heart sounds.
  • Tests:
    1. Arterial blood gas test -- blood oxygen levels are lower than normal (hypoxia).
    2. Blood test may show that carbon dioxide levels are lower than normal (hypocarbia).
    3. Other blood tests may be necessary in diagnosing the cause (e.g., high CPK levels in heart attack and Amylase in pancreatitis).
    4. Chest X-Ray will show fluid in the lungs.
    5. Electrocardiogram (measures electrical activity of the heart), Echocardiogram (uses sound waves to create a picture of the heart), and CAT scan can also be helpful in pinpointing the exact cause of the edema.
    6. A cardiologist (heart doctor) may be called to perform a cardiac catheterization or Swan-Ganz catheterization, which are techniques that can provide valuable information about the heart and edema.

  • See causes

  • Treat underlying cause
  • Aim is to treat symptoms and remove or reduce the fluid
  • In sudden, severe cases:
    1. Oxygen as needed
    2. Morphine, furosemide, nitroglycerin, and other medications are given in the hospital to reduce Anxiety, improve circulation, and promote fluid excretion (diuresis) or peeing excess fluid.
    3. The patient, once admitted, receives drugs (diuretics) over the next several days to assist in gradually reducing excess fluid (urination removes excess body water).
    4. The weight and amount of fluid taken in and urinated is carefully measured.
    5. Low salt diet
    6. Fluid restriction
    7. Before discharge, the patient sees a cardiologist and is sent home with a treatment plan and medications.

  • Call 911 if symptoms such as shortness of breath and chest pain appear suddenly.

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