ACUTE PULMONARY OEDEMA

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 Case Scenario: 

                          The patient was a 64 years old woman, with a history of monoclonal gammopathy of undermined significance and hepatitis B, admitted to the hospital with Flash pulmonary edema. On observation, The patient has intense dyspnoea, diaphoresis, cyanosis, and peripheral vasoconstriction suggesting cardiogenic shock; the pulse pressure was normal, and the pulse was rapid and thread. Although at first cardiac auscultation was apparently non-revealing because of the pulmonary findings supremacy, a later detailed examination after patient improvement and ward admittance revealed an early diastolic murmur, respective of aortic regurgitation.

Epidemiology: 

                              The prevalence of pulmonary edema was estimated to be 75,000 to 83,000 per 100,000 heart failure patients with reduced ejection fraction. Pulmonary edema usually affects individuals older than 60 years of age. Males are commonly affected more by pulmonary edema than women.

Causes:

  1. If a heart problem causes pulmonary edema, it is called cardiogenic pulmonary edema. most often, the fluid build-up in the lungs is due to a heart condition. 
  2.  If pulmonary edema is not heart-related, it is called non-cardiogenic pulmonary edema. 
  3. Sometimes pulmonary edema can be caused by both a heart problem and a non-heart problem.        

Symptoms:

  1. Difficulty breathing(Dyspnea) or extreme shortness of breath that worsens with activity or when lying down.
  2. A feeling of suffocating or drawing especially that worsens when lying down
  3. A cough that produces frothy sputum that may be tinged with blood.
  4. Wheezing or gasping for breath
  5. Cold, clammy skin
  6. Anxiety, restlessness, or a feeling of apprehension.
  7. Bluish lips.
  8. A Rapid irregular heartbeat.

Complications:

  1. Breathing Difficulty
  2. Swelling of the feet, legs, and abdomen
  3. A build-up of fluid in the membranes that surround your leg(Pleural effusion)
  4. Congestion and swelling of the liver. 

Diagnosis:

                 Tests that will be done to diagnose acute pulmonary edema are as follows.  

  1. Chest x-ray
  2. Chest C.T
  3. Pulse oximetry
  4. Arterial blood gas test
  5. B-type natriuretic peptide(BNP) blood test.
  6. Other blood tests( CBC, Thyroid function test, Metabolic panel)
  7. Electrocardiogram
  8. Echocardiogram
  9. Cardiac catheterization and coronary angiogram
  10. Ultrasound of lungs.

 Treatment:

                  The very first treatment of acute pulmonary edema is the supply of supplemental oxygen and when the condition stabilizes then as seeing the severity of the condition one of these medicines will be given to you. 

  1. Diuretics
  2. Morphine
  3. Blood pressure drugs
  4. Inotropes.

References:

  1. The Case Scenario is from NCBI and their URL is https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025367/
  2. Epidemiology is from wikidoc whose major editors are  C. Michael Gibson, M.S., M.D., and Farnaz Khalighinejad, MD and the URL to the website is https://www.wikidoc.org/index.php/Pulmonary_edema_epidemiology_and_demographics#:~:text=The%20prevalence%20of%20pulmonary%20edema,by%20pulmonary%20edema%20than%20woman.
  3. The Symptoms, Causes, and complications are from mayo clinic and their URL is                  https://www.mayoclinic.org/diseases-conditions/pulmonary-edema/symptoms-causes/syc-20377009
  4. Diagnosis and treatment is from mayo clinic and the URL is https://www.mayoclinic.org/diseases-conditions/pulmonary-edema/diagnosis-treatment/drc-20377014          





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