What Should be Done in Pulmonary Edema
Pulmonary edema is an acute, dramatic, and sometimes life-threatening symptom of heart failure . The edema, or swollen tissue, results from inefficient pumping action of the left side of the heart. This causes the blood in the pulmonary veins, which bring oxygenated blood to the heart from the lungs, to become dammed up. This raises the pressure in these and other blood vessels in the lungs. As a result, fluid seeps from the blood vessels into the alveoli, the saclike parts of the lungs where oxygen and carbon dioxide are exchanged. An accumulation of fluid leads to swollen lungs. If you have this problem, and you suddenly become breathless, it is called an attack of pulmonary edema. This some times happens to someone who has heart failure and is not aware of it.
What are the Symptoms?
An attack of pulmonary edema consists of breathlessness that becomes progressively worse over a few hours. This often occurs in the middle of the night. You may have a frightening sense of needing to fight for breath. The breathlessness is generally accompanied by a cough, which is dry and tickling in the early stages, but which may eventually bring up blood-stained, frothy phlegm, or sputum. In a severe attack you may also turn bluish because there is not enough oxygen in your blood.
What should be Done?
If you have an attack of pulmonary edema, you may already be under treatment for heart failure. At the first sign of sudden severe breathlessness, contact your physician and call for an ambulance. This is an emergency that will respond to treatment, but delay may be fatal. Do not dispose of your sputum, since is will probably be tested to help your physician confirm that you have pulmonary edema, rather than some other malady with similar symptoms. Your blood pressure will probably be taken and your chest examined with a stethoscope. You will also probably be asked if you have chest pain. Pain in addition to breathlessness may indicate that you are also having a coronary thrombosis, or heart attack.
What is the Treatment?
Self-help: Try to keep calm. Sit up in a chair to make breathing easier. It will probably help you considerably if you straddle the chair, facing backwards, with your arms raised and resting on its back.
Professional help: The main objective is to relieve the breathlessness as quickly as possible. This is usually done best in a hospital, where you can be given oxygen. Your physician may prescribe one of several drugs, any of which can be injected directly into a vein to act swiftly. Morphine is used to slow and deepen breathing. A diuretic will help to drain fluid from your lungs, or open up blocked air spaces in the lungs. If you are not already taking digitalis, the doctor may also start you on it to strengthen the action of your heart. If the attack of pulmonary edema has been triggered by a chest infection, your physician may prescribe an antibiotic as well.
If pulmonary edema is treated rapidly and efficiently, and if your attack has not been brought on by a heart attack, your stay in the hospital may be no longer than a week or so. Your physician will probably continue to treat you for heart failure in order to prevent further complications.