3. Imagine yourself sinking deep into the sea ,
ALONE , surrounded by darkness
Your heart beating fast ,
Laborious breathing ,
effortlessly and with pain
Feeling the end is near ,
Your hands looking pale
Trembling from fear
You are too breathless to speak or to shout for
help
ACUTE PULMONARY EDEMA
THROW A LIFE JACKET TO
DROWNING PATIENT
4. Definition:
• Pulmonary edema is a condition characterized by fluid
accumulation in the lungs caused by back pressure in the lung
veins. This results from malfunctioning of the heart.
6. Causes:
Pulmonary edema is a complication of a myocardial
infarction (heart attack), mitral or aortic valve disease,
cardiomyopathy, or other disorders characterized by
cardiac dysfunction.
Usually the heart will act on the first factor
Oncotic pressure depends on albumin
3rd
factor is influenced by lung causes
Could be cardiogenic and non cardiogenic
7. Pathophysiology:
• Fluid backs up into the veins of the lungs. Increased pressure
in these veins forces fluid out of the vein and into the air spaces
(alveoli). This interferes with the exchange of oxygen and
carbon dioxide in the alveoli.
8. Symptoms:
• Extreme shortness of breath, severe difficult breathing
• Feeling of "air hunger" or "drowning"
• "Grunting" sounds with breathing
• Inability to lie down
• Rales
• Wheezing
• Anxiety
10. Signs:
• Listening to the chest with a stethoscope (auscultation) may
show crackles in the lungs or abnormal heart sounds.
• A chest x-ray may show fluid in the lung space.
• An echocardiogram may be performed in addition to (or instead
of) a chest x-ray.
11. Tests:
Blood oxygen levels (low)
A chest X-ray may reveal the following:
Fluid in or around the lung space
Enlarged heart
12. Tests:
An ultrasound of the heart (echocardiogram) may reveal the
following:
Weak heart muscle
Leaking or narrow heart valves
Fluid surrounding the heart
13. Treatment:
• This is a medical emergency! Do not delay treatment.
Hospitalization and immediate treatment are required.
• Oxygen is given, by a mask or through endotracheal tube
using mechanical ventilation.
14. Treatment:
• Medications include diuretics such as furosemide to remove
fluid, vasodilators to help the heart pump better, drugs to treat
anxiety, and other medications to treat the underlying cardiac
disorder.
16. Expectations (Prognosis):
• Pulmonary edema is a life-threatening condition. It is often
curable with urgent treatment and subsequent control of the
underlying disorder.
18. Patient Education:
• Go to the emergency room or call the local emergency number
(such as 999) if conditions suggesting pulmonary edema occur,
particularly if breathing is difficult.
• In patients with known diseases that can lead to pulmonary
edema, strict compliance with taking medications in a timely
manner and following an appropriate diet (usually, low in salt)
can significantly decrease one's risk