Cardiogenic Pulmonary Edema

What is cardiogenic pulmonary edema?

Cardiogenic pulmonary edema is an accumulation of extra fluid in your lungs that can be life-threatening. This comes from pressure going up and blood collecting on the left side of your heart, usually because of heart failure. In addition to difficulty breathing, cardiac edema can lead to organ damage from a lack of enough oxygen.

Cardiac edema vs. pulmonary edema

Both of these mean you have too much fluid in your lungs, which makes it hard for you to breathe. Cardiogenic pulmonary edema is a type of pulmonary edema with a heart problem as its cause. An injury to your lungs causes the non-cardiogenic type of pulmonary edema.

Cardiac edema vs. renal edema

These are both names for excess fluid in your organs. With cardiac edema, there’s too much fluid in your lungs. With renal edema, there’s too much fluid in your kidneys. Heart failure can cause both of these. Also, your kidneys can’t get enough fluid out of your blood and into your pee.

Who does heart edema affect?

Cardiac edema affects people with heart conditions, especially heart failure. About 6 million American adults have heart failure. An estimated 80% of people with heart failure have pulmonary edema.

What are the symptoms?

Symptoms of cardiogenic pulmonary edema include:

• Difficulty breathing when exerting yourself or lying down.
• Shortness of breath that wakes you from sleep.
• Swelling in your legs.
• Tiredness.
• Weight increase of more than two pounds a day.

What causes cardiogenic pulmonary edema?

Congestive heart failure is the most common cause of heart edema. Other causes include:

• Abnormal heart rhythm (arrhythmia).
• Cardiomyopathy.
• Problems with the valves on the left side of your heart, such as narrowing or regurgitation (blood going the wrong way).
• Heart attack.

How is cardiac edema diagnosed?

Your healthcare provider will:

• Do a physical exam.
• Ask you about your medical history.
• Do testing.

What tests will be done to diagnose heart edema?

After your exam, your provider may order these tests that help show what’s going on:

• Electrocardiogram (EKG).
• Chest X-ray.
• Echocardiogram.
• Blood tests.
• Pulmonary arterial catheter (using a catheter to check the pressure in your pulmonary artery).

How is cardiogenic pulmonary edema treated?

Procedures or invasive treatments for cardiac edema include:

• Percutaneous coronary intervention (PCI).
• Ventricular assist device.
• Heart valve replacement.
• Coronary artery bypass graft.
• Intra-aortic balloon pump (IABP), which helps your heart pump better.
• Extracorporeal membrane oxygenation (ECMO).
• Heart transplant.

What medications are used?

Your healthcare provider may prescribe:

• Vasodilators to widen your blood vessels.
• Diuretics to help you get more fluids out of your body.

If you have heart failure, your healthcare provider will ask you to take salt out of your diet. This includes salt you add to food and salt that’s already in prepared or processed foods.

Other things that may help:

• Exercising on most days of the week.
• Raising your swollen legs up when you’re sitting.
• Wearing support (compression) stockings for swollen legs.
• Raising the head of your bed if you have fluid in your lungs.

How can I reduce my risk?

Since cardiogenic pulmonary edema happens when you already have a problem with your heart, the best way to reduce your risk is by keeping your heart strong and healthy.

Ways to do that include:

• Eating foods that are low in saturated fats and trans fats.
• Exercising every day.
• Not using tobacco products.
• Limiting how much alcohol you drink.

What can I expect if I have cardiogenic pulmonary edema?

Pulmonary edema is life-threatening, but your prognosis depends on what caused it. One year after discharge from a hospital, about 50% survive cardiac edema.

Heart failure, a common cause of cardiogenic pulmonary edema, is a chronic disease that can get better with treatment. Out of every three people who’ve been in the hospital because of heart failure, one person lives five or more years after their stay.

How do I take care of myself?

Weighing yourself every day at the same time can help you know if your cardiac edema is getting worse. It may be easiest to step on your scale before breakfast, but after you pee. If you gain more than two pounds a day, your body is probably retaining fluid.

When should I see my healthcare provider?

You should contact your provider if you have:

• A hard time breathing when you exert yourself or lie down.
• Shortness of breath that makes you wake up.
• Swollen legs.

When should I go to the ER?

Call 911 if you’re having trouble breathing or if you’re having chest pain.

What questions should I ask my doctor?

• What’s the cause of my cardiac edema?
• Can you treat what’s causing my cardiac edema?
• What changes do I need to make to how I live?

A note from Cleveland Clinic

When your healthcare provider diagnoses and treats your cardiogenic pulmonary edema early, it’s better than if you wait to get care. This is why it’s good to keep going to your regular checkups with your provider. They can keep an eye on any cardiac issues you have that may lead to cardiac edema. Taking the medicines they give you can prevent heart problems you have from getting worse.