Pulmonary edema – diagnosis and therapy

How is the diagnosis made?

The suspected diagnosis based on the medical history and observation is usually confirmed by tapping and listening to the lungs. The usual X-ray of the chest also shows typical changes, which differ depending on the severity.

With an ECG and a heart ultrasound (echocardiography), statements can be made about any underlying heart disease, and the pressure conditions in the lungs and vessels can be assessed. A blood gas analysis to determine oxygen and carbon dioxide content in the blood from the earlobe or wrist can be used to determine how severe the breathing disorder is.

What therapy is there for pulmonary oedema?

The treatment of the possibly life-threatening clinical picture belongs to a doctor in the hospital. The first step is to make it easier for the patient to breathe. To relieve the heart, the patient is seated with the upper body elevated and the legs hanging low, and oxygen is administered via a nasal tube or face mask.

In very severe cases, the patient must be temporarily artificially ventilated. Sometimes secretions are sucked out of the bronchi through the nose. The patient may be given pain medication; sedatives can be given if he is very restless. However, these can suppress fears and breathing, which is why close monitoring is necessary.

Further therapy depends on the cause of pulmonary oedema. For example, in the case of left heart failure, drugs are given that reduce the load on the heart ( nitroglycerin and diuretics = diuretics). If toxins or allergies are the trigger, a cortisone preparation is administered, and dialysis is indicated in the case of kidney weakness.

What’s the prognosis?

The course of pulmonary oedema is generally good with appropriate, prompt treatment. Pneumonia rarely develops. However, the overall prognosis for the person affected depends on the underlying disease.