Pulmonary Hypertension and Edema
Edema often occurs as the result of congestive heart failure. An array of conditions — congestive heart failure and lung, liver, kidney, and thyroid What's the Connection With Congestive Heart Failure? The blood can then back up in the legs, ankles, and feet, which leads to swelling, or edema. Pulmonary edema is a condition in which the lungs fill with fluid. gain, especially in the legs; swelling in the lower part of the body; fatigue The most common cause of pulmonary edema is congestive heart failure (CHF). In most cases, heart problems cause pulmonary edema. Understanding the relationship between your heart and lungs can help explain why. . from blood vessels in your legs to your lungs, can lead to pulmonary edema.
The aortic valve at the base of the aorta keeps the blood from flowing backward into your heart. From the aorta, the blood travels to the rest of your body. Heart-related cardiogenic pulmonary edema Cardiogenic pulmonary edema is a type of pulmonary edema caused by increased pressures in the heart. This condition usually occurs when the diseased or overworked left ventricle isn't able to pump out enough of the blood it receives from your lungs congestive heart failure.
As a result, pressure increases inside the left atrium and then in the veins and capillaries in your lungs, causing fluid to be pushed through the capillary walls into the air sacs. Medical conditions that can cause the left ventricle to become weak and eventually fail include: Over time, the arteries that supply blood to your heart muscle can become narrow from fatty deposits plaques.
A heart attack occurs when a blood clot forms in one of these narrowed arteries, blocking blood flow and damaging the portion of your heart muscle supplied by that artery.
The result is that the damaged heart muscle can no longer pump as well as it should. Sometimes, a clot isn't the cause of the problem. Instead, gradual narrowing of the coronary arteries can lead to weakness of the left ventricular muscle. Although the rest of your heart tries to compensate for this loss, there are times when it's unable to do so effectively. The heart can also be weakened by the extra workload. When the pumping action of your heart is weakened, blood gradually backs up into your lungs, forcing fluid in your blood to pass through the capillary walls into the air sacs.
This is chronic congestive heart failure. When your heart muscle is damaged, the condition is called cardiomyopathy. Because cardiomyopathy affects the function of the ventricles — your heart's main pump — your heart may not be able to respond to conditions that require it to work harder, such as a surge in blood pressure, a faster heartbeat with exertion, or consuming too much salt in the diet that causes water retention or infections.
When the left ventricle can't keep up with the demands that are placed on it, fluid backs up into your lungs. In mitral valve disease or aortic valve disease, the valves that regulate blood flow in the left side of your heart may not open wide enough stenosis. Or, they don't close completely, allowing blood to flow backward through the valve insufficiency or regurgitation.
When the valves are narrowed, blood can't flow freely into your heart and pressure in the left ventricle builds up, causing the left ventricle to work harder and harder with each contraction.
The left ventricle also dilates to allow greater blood flow, but this makes the left ventricle's pumping action less efficient. The increased pressure extends into the left atrium and then to the pulmonary veins, causing fluid to accumulate in your lungs. On the other hand, if the mitral valve leaks, some blood is backwashed toward your lung each time your heart pumps.
If the leakage develops suddenly, you may develop sudden and severe pulmonary edema. High blood pressure hypertension. Untreated or uncontrolled high blood pressure can enlarge the heart.
Other conditions may lead to cardiogenic pulmonary edema, such as high blood pressure due to narrowed kidney arteries renal artery stenosis and fluid buildup due to kidney disease or heart problems. Non-heart-related noncardiogenic pulmonary edema High-altitude pulmonary edema High-altitude pulmonary edema In normal lungs, air sacs alveoli take in oxygen and release carbon dioxide.
In high-altitude pulmonary edema HAPEit's theorized that vessels in the lungs constrict, causing increased pressure. This causes fluid to leak from the blood vessels to the lung tissues and eventually into the air sacs. Pulmonary edema that isn't caused by increased pressures in your heart is called noncardiogenic pulmonary edema.
In this condition, fluid may leak from the capillaries in your lungs' air sacs because the capillaries themselves become more permeable or leaky, even without the buildup of back pressure from your heart. Some factors that can cause noncardiogenic pulmonary edema include: Acute respiratory distress syndrome ARDS. This serious disorder occurs when your lungs suddenly fill with fluid and inflammatory white blood cells.
Many conditions can cause ARDS, including severe injuries traumasystemic infection sepsispneumonia and severe bleeding. Mountain climbers and people who travel to high-altitude locations run the risk of developing high-altitude pulmonary edema HAPE. This condition — which generally occurs at elevations above 8, feet about 2, meters — can also affect hikers or skiers who start exercising at higher altitudes without first becoming acclimated, which can take from a few days to a week or so.
But even people who have hiked or skied at high altitudes in the past aren't immune. Although the exact cause isn't completely understood, HAPE seems to develop as a result of increased pressure from constriction of the pulmonary capillaries. Without appropriate care, HAPE can be fatal, but this risk can be minimized. A type of pulmonary edema called neurogenic pulmonary edema can occur after some nervous system conditions or procedures — such as after a head injury or seizure — or after brain surgery.
Pulmonary edema: MedlinePlus Medical Encyclopedia
Many drugs — ranging from illegal drugs such as heroin and cocaine to aspirin — are known to cause noncardiogenic pulmonary edema. Negative pressure pulmonary edema. Pulmonary edema can develop after a blockage in the upper airway causes negative pressure in the lungs from intense efforts to breathe despite the blockage. Pulmonary embolism, a condition that occurs when blood clots travel from blood vessels in your legs to your lungs, can lead to pulmonary edema.
Pulmonary edema can be caused by viral infections such as the hantavirus and dengue virus. Exposure to certain toxins. These include toxins you inhale as well as those that may circulate within your own body, for example, if you inhale aspirate some of your stomach contents when you vomit.
Inhaling toxins causes intense irritation of the small airways and alveoli, resulting in fluid accumulation. Smoke from a fire contains chemicals that damage the membrane between the air sacs and the capillaries, allowing fluid to enter your lungs.
Inhaling water causes noncardiogenic pulmonary edema that is reversible with immediate attention. Complications If pulmonary edema continues, it can raise pressure in the pulmonary artery pulmonary hypertensionand eventually the right ventricle in your heart becomes weak and begins to fail. The right ventricle has a much thinner wall of muscle than does the left side of your heart because it is under less pressure to pump blood into the lungs.
The increased pressure backs up into the right atrium and then into various parts of your body, where it can cause: Lower extremity and abdominal swelling Buildup of fluid in the membranes that surround your lungs pleural effusion Congestion and swelling of the liver Left untreated, acute pulmonary edema can be deadly.
In some instances, it may be fatal even if you receive treatment. Prevention Preventing conditions and situations that cause pulmonary edema can help keep pulmonary edema from developing. These measures can help reduce your risk. Preventing cardiovascular disease Cardiovascular disease is the leading cause of pulmonary edema.
You can reduce your risk of many kinds of heart problems by following these suggestions: This may cause swelling in the legs or a build-up of fluid in the abdomen. If the person spends a lot of time lying down, the edema might show up on his or her back called sacral edema. Congestive heart failure can also cause edema in the lungs pulmonary edema.
This is not common, but the condition is life-threatening. It means the lungs are filling with fluid because the left side of the heart is not strong enough to pump the blood returning from the lungs. The blood gathers in the blood vessels of the lung, and fluid seeps out into the lung tissue. The signs are shortness of breath and rapid, shallow breathing or coughing.
Kidney disease could cause edema in the legs and around the eyes, because when the kidneys do not remove enough sodium and water from the body, the pressure in the blood vessels starts building up, which can lead to edema.
Low protein levels in the blood: If there is a lack of the protein albumin in the blood, fluid can leak out of blood vessels more easily.
Low protein in the blood can be caused by extreme malnutrition, as well as kidney and liver diseases which mean that the body loses too much or produces too little protein. Scarring of liver tissue liver cirrhosis due to, for instance, long-term alcohol abuse or a liver inflammation, can cause edema in the abdomen called ascites.
This is because cirrhosis causes a lack of proteins and congestion in the liver, which can lead to increased pressure in the blood vessels. As a result, fluid seeps out into the abdomen.
Severe lung conditions like emphysema can also cause edema in the legs and feet if the pressure in the lungs and heart gets very high.
What to Do If You Have Edema
Lymphedema This is caused by damage to the lymphatic system. It usually affects only one part of the body, like an arm. The most common cause of lymphedema in countries like Germany is cancer treatment in which lymph nodes have been removed or destroyed.
It could be temporary after cancer surgery, but it can also develop into a chronic condition that can become severe. Lexikon der Krankheiten und Untersuchungen. IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.
Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. We do not offer individual consultations.
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