Pulmonary Edema Causes Diagnosis with Treatment

Edema is defined as a palpable swelling produced by expansion of the interstitial fluid volume. When the left ventricle is not able to eject all the blood effectively there is pulmonary conges­tion, systemic hypoperfusion, and exudation of fluid and blood elements into the alveoli; this is called Pulmonary edema.

Pulmonary Edema 2

Pulmonary Edema Causes Diagnosis with Treatment

  • Fluid from the pulmonary vasculature leaks into the interstitium and alveoli of the lung.
  • Fluid accumulation occurs when there is an imbalance of hydrostatic and oncotic pressures within the pulmonary capillaries and in the surrounding tissue.
  • Commonest cause of pulmonary edema is left ven­tricular dysfunction.
  • Left ventricular dysfunction leads to decreased per­fusion of the systemic circulation, so there is :
  • Fall in cardiac output/cardiac index to less than 2,2 L/min/m2
  • Systolic blood pressure <90 mmHg.
  • Pulmonary capillary wedge pressure> 18 mmHg.
  • All these features comprise cardiogenic shock.
  • Cardiogenic shock is a fall in systemic perfusion pressure with circulatory failure, leading to shock.

Pulmonary Edema Risk Factors

  • Cardiogenic

    • HTN
    • Myocardial infarction (MI)
    • Diabetes mellitus (DM)
    • Smoking
    • Coronary heart disease
    • Valvular heart disease
  • Noncardiogenic

    • Sepsis
    • Reexpansion of lung after injury
    • High altitude
    • Burns
    • Neurologic diseases
    • Medications

Etiology of Cardiogenic shock and Pulmonary edema

  • Acute myocardial infarction Ventricular septal rupture Papillary muscle rupture
  •  Rupture of Cordae tendinae Tachya rrhyth mias Bradyarrhyth m ias
  • Myocarditis
  • Cardiomyopathy Aortic dissection
  • Pulmonary embolization Severe MS
  • Severe AS
  • Severe AR
  • Severe MR
  • Beta blocker overdose
  • Cardiac tamponade.

Investigations for Pulmonary Edema

  • Blood tests
  • ECG
  • Chest X-ray
  • 2D echo
  • Doppler studies
  • Pulmonary artery catheterization
  • Left heart catheterization
  • Coronary angiography.

Treatment of Pulmonary Edema

  • inhalation
  • Propped up position
  • Treatment of hypoxaemia, acidosis
  • Treatment of MI
  • Endotracheal intubation
  • Treat hyperglycemia
  • Treat arrhythmias
  • Nitroglycerine, Isosorbide dinitrate
  • Diuretics
  • Morphine
    • 2 – 10 mg IV ACE inhibitors
  • Digitalis
  • Norepine hrine
    • 2 to 4 to 15 g/min.
  • Dopamin
    • 2 to 10 IJg/kg/min
  • Maximum 50 lJg/kgjmin
  • Dobutamine
    • – 2.5 to 10 IJg/kg/min
  • Xanthines-aminophylli ne Aortic counterpulsation Ventricular assist devices Cardiac transplantation Reperfusion therapy.


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