Pulmonary Edema: Causes, Symptoms, Diagnosis

October 21, 2020 by ChestMed Pte Ltd.3

Pulmonary edema, also known as pulmonary congestion, lung congestion, and lung water is a condition characterized by excess fluid in the lungs. When pulmonary edema occurs, the body struggles to get ample oxygen and the patient experiences shortness of breath. 

If you suspect you have pulmonary edema, seeing a lung doctor right away is recommended. The good thing is, prompt lung congestion treatment can improve outcomes significantly.


Pulmonary edema can be attributed to several causes. The following are some of the possible causes of pulmonary edema.

Congestive heart failure

The most prevalent cause of pulmonary edema is congestive heart failure (CHF). Heart failure occurs when the heart is no longer able to properly pump blood throughout the body. When this happens, a backup of pressure in the lung’s small blood vessels is created. This causes the vessels to eventually leak fluid.

In healthy individuals, the lungs takes oxygen from the air and puts it into the bloodstream. However, when the lungs are filled with fluid, no oxygen makes it into the bloodstream. This causes the rest of the body to be deprived of oxygen as well. 

Other medical conditions

Other less common medical issues that can cause pulmonary edema include:

  • Narrowed, damaged, or leaking heart valves
  • Pneumonia
  • Kidney failure
  • Heart attack (or other heart diseases)
  • Lung damage secondary to severe infection
  • Sudden high blood pressure
  • Severe blood sepsis

External factors

A few external factors might also put extra pressure on the lungs and heart and cause pulmonary edema. Outside factors that can result to pulmonary edema include:

  • Drug overdose or illicit drug use
  • High altitude exposure
  • Severe trauma
  • Near drowning
  • Major injury
  • Lung damage (secondary to inhalation of toxins)


Symptoms patients will experience will depend on the type of pulmonary edema they have. For instance:

Long-term pulmonary edema

Common symptoms of pulmonary edema include:

  • Shortness of breath (when physically active)
  • Wheezing
  • Difficulty breathing (especially when lying down)
  • Drastic weight gain (especially in the legs)
  • Fatigue
  • Swelling in the lower part of the body

High-altitude pulmonary edema

Pulmonary edema brought about by altitude sickness (or not getting enough oxygen) will exhibit the following symptoms:

  • Rapid and irregular heartbeat
  • Headaches
  • Coughing
  • Fever
  • Shortness of breath (after exertion and even during rest)
  • Difficulty walking uphill (and even on flat surfaces)


To diagnose pulmonary edema, your doctor will look for fluid in the lungs. Basic physical examination may also be performed. Your doctor may also listen to the lungs with a stethoscope to look for signs of:

  • Increased heart rate
  • Crackling sound from the lungs
  • Abnormal heart sounds
  • Rapid breathing

The neck may also be examined to check for fluid buildup. Your doctor may also check for signs of swelling in the legs and abdomen or if you have blue-colored or pale skin. If your doctor suspects you have fluid in your lungs, additional tests may be ordered, including:

  • Echocardiogram or ultrasound (to check for any abnormal heart activity)
  • Complete blood count
  • Blood tests (to check for oxygen levels)
  • Chest X-ray (to check for fluids)
  • Electrocardiogram (ECG) (to look for signs of a heart attack or heart rhythm problems)


Pulmonary edema is considered a serious condition that requires fast treatment. Oxygen is always the first line of defense for pulmonary edema. You may be given 100 percent oxygen through a positive pressure mask, nasal cannula, or through an oxygen mask. 

Your doctor will also look into the cause of the pulmonary edema and prescribe the right medications to treat the underlying cause. Depending on the cause, the following may also be prescribed:

  • Preload reducers (medications that reduce the workload of the heart)
  • Heart medications
  • Afterload reducers (medications that reduce the workload of the heart)
  • Morphine


ChestMed Pte Ltd.


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