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Acute pulmonary edema


Acute pulmonary edema is characterized by the presence of fluid in the alveoli. The latter may occur gradually or suddenly, which is the case for acute pulmonary edema. Its acute form may be due to two main cases:
  • an increase in pulmonary artery pressure, in which case we speak of cardiogenic pulmonary edema: there is a leaking of blood vessels due to an excessive pressure. This mechanism may occur with many cardiac diseases, such as arrhythmia, heart disease, heart failure;
  • a trauma causing a rupture of the membrane between the vessels and alveoli: we speak in this case of ARDS (acute respiratory distress syndrome).

The presence of fluid in the alveoli will be responsible for a decrease in the quality of air exchange and will cause severe breathing difficulties depending on the severity of fluid invasion.


Acute pulmonary edema is characterized by:
  • difficulty breathing, sudden onset with increased respiratory rate;
  • increased discomfort when lying down;
  • Sometimes, the presence of chest pain;
  • coughing;
  • bluish discoloration of the skin or mucous membranes;
  • frothy sputum.


In cases of suspected acute pulmonary edema, care must be carried out quickly. The doctor will inquire only on the important patient history, including pre-existing heart disease, and the circumstances of onset, the presence of trauma or not. A clinical examination with auscultation will confirm the existence of fluid in the lungs. If necessary, and if the patient is stable enough, a chest X-ray, an electrocardiogram, a blood test measuring arterial gases, or an echocardiogram will be performed.


The treatment of acute pulmonary edema systematically includes:
  • a vasodilator drug that dilates the blood vessels to allow better blood circulation;
  • injections of diuretics to remove excess water;
  • the use of other medicines called nitrates;
  • oxygen;
  • and lastly, the cause must also be treated.


Aside from taking care of all other cardiovascular risk factors common to everyone, patients with heart disease must adhere to a number of specific rules to avoid complications. A salt-free diet, a balanced diet, weight control, a well-followed treatment, blood pressure control, lack of smoking and limited alcohol consumption are some of the basic principles to avoid the occurrence of these complications.