Introduction:

Pulmonary edema occurs when increased pressure in the blood vessels in your lungs causes them to fill up with fluid. It is often caused by heart disease, acute severe asthma, pneumonia, or exercising at high altitudes. It can also occur after a blood transfusion. Pulmonary edema is a serious condition requiring immediate medical attention.

Signs and Symptoms:

Symptoms often begin suddenly and get worse quickly. They include:

• Extreme shortness of breath and difficulty breathing
• Tightness and pain in the chest
• Wheezing, coughing
• Paleness
• Sweating
• Bluish nails and lips
• Pink, frothy mucus coming from nose and mouth

What Causes It?:

The most common cause of pulmonary edema is heart failure, but not all cases are related to heart function. Some risk factors for pulmonary edema include:

• High blood pressure
• Diabetes
• Coronary or valvular heart disease
• Obesity
• Exposure to high altitude
• Central nervous system injury
• Infection
• Hanta virus
• Inhaled toxins

What to Expect at Your Provider's Office:

Pulmonary edema is life threatening and requires immediate treatment. Once the initial attack is under control, your health care provider will order blood tests and a urine test to determine what caused the attack. Other tests may include a chest x-ray, electrocardiogram, echocardiogram, transesophageal echocardiogram, or cardiac catheterization. Your health care provider may also recommend internal thoracic impedance monitors for at-risk patients. In acute pulmonary edema, continuous positive airway pressure and non-invasive positive pressure ventilation are accepted treatments.

Treatment Options:

Medications may include diuretics to remove excess fluid from the lungs, blood pressure medication, aspirin to thin the blood, and drugs to dilate blood vessels. In rare cases, surgery may be needed.

Complementary and Alternative Therapies

Pulmonary edema should be treated with conventional medications. Alternative therapies can supplement this care, helping to strengthen the cardiopulmonary system, but should never be used alone to treat pulmonary edema. Make sure to inform all of your medical providers of any alternative therapies or supplements you may be using.

Nutrition and Supplements

• Depending on what kind of diuretic you take, you may need to increase potassium and magnesium in your diet (for example, by eating bananas, apricots, nuts, seeds, and green leafy vegetables). Ask your doctor if you need more magnesium and potassium.
• Coenzyme Q10 (100 mg two times per day) supports cardiac function.
• L-carnitine (500 mg three times per day) improves endurance.
• Magnesium aspartate (200 mg two to three times per day) increases efficiency of cardiac muscle. Magnesium and calcium (1,000 mg per day) improve fluid exchange in the body. Note: Both interact with several medications, herbs, and supplements, so talk to your doctor before taking these supplements.
• Potassium improves the ability of heart muscle to contract. Depending on the type of diuretic you take, your doctor may recommend you also take a potassium supplement. The dose will depend on the level of potassium in your blood, so your doctor will determine the proper amount.
• Vitamin E (400 IU per day) is an antioxidant that protects the heart.
• Vitamin C (1,000 - 1,500 mg three times per day) is an antioxidant.
• Taurine (1,000 mg twice a day) enhances cardiac function in people with congestive heart failure.
• Thiamin (vitamin B1, 200 mg per day) may improve cardiac function in people with heart failure, although studies show mixed results.
• L-arginine (6 g per day), an amino acid, may improve cardiac function in people with heart failure.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to diagnose your problem before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.

For pulmonary edema that does not originate with the heart:

• Garlic (Allium sativum) helps you cough up mucus, lowers blood pressure, and stimulates your immune system. (Garlic can also be taken as capsules, 1,000 - 4,000 mg per day.)
• Rosemary (Rosmarinus officinalis) strengthens cardiac function. Drink 1 cup tea three times per day. To make tea, steep 1 - 2 g of leaves in one cup boiling water, strain, and cool.
• Horse chestnut (Aesculus hippocastanum). Take 250 mg two times per day, standardized for aescin content. Use only reputable brands that have been professionally formulated. Crude preparations can contain a toxic compound. Do not use if you have liver or kidney disease or take blood-thinning medication, and do not exceed recommended dosage.
• Horsetail (Equisetum arvense). Your doctor should determine the dose. Do not take horsetail if you have high blood pressure or heart disease, and take it only under the supervision of a doctor.
• Thyme leaf (Thymus vulgaris) helps you cough up mucus, tones the respiratory system, and increases circulation.
• Scotch broom (Cytisus scoparius). Drink 1 cup tea three times per day. To make tea, steep 1 - 2 g of rosemary leaves in one cup boiling water, strain, and cool.

For pulmonary edema originating with the heart, especially heart failure, you may use the following herbs. It is important to get a diagnosis from your doctor concerning the type of heart disease, as various herbs are used for different conditions.

• Hawthorn (Crataegus monogyna), 240 - 600 mg per day. Hawthorn is used in many types of heart disease.
• Linden (Tilia cordata), 1 - 2 cups tea per day. To make tea, steep 2 g in one cup boiling water, strain, and cool.
• Asian ginseng (Panax ginseng), 200 - 600 mg per day.
• Goldenseal (Hydrastis canadensis), 500 - 1,000 mg three times per day.
• Forskohlin (Coleus forskohlii), 50 - 100 mg two to three times a day.
• Astragalus (Astragalus membranaceus). The dose should be determined by your doctor.
• Passionflower (Passiflora incarnata). Drink 3 cups tea per day. To make tea, steep 2 g in one cup boiling water, strain, and cool.
• Barberry (Berberis vulgaris). Take 250 - 500 mg three times per day.
• Ginkgo (Ginkgo biloba). Take 120 - 240 mg in two or three divided doses per day. Do not take ginkgo if you take blood-thinning medication or have diabetes.

Homeopathy

Homeopathy may be useful as a supportive therapy.

Physical Medicine

Alternating hot and cold applications with hand or foot baths may help circulation. Alternate 3 minutes hot with 1 minute cold. Repeat three times to complete one set. Do two to three sets per day.

Movement helps the body naturally distribute accumulated fluids. Ask your doctor about the level of physical activity that would be safe and beneficial for you. One study found that intense interval training can cause mild, detectable pulmonary edema.

Castor oil pack. Apply oil directly to the chest, cover with a clean soft cloth and plastic wrap. Place a heat source over the pack, and let sit for 30 - 60 minutes. Repeat four to six times per week.

Acupuncture

Acupuncture may improve cardiopulmonary function.

Massage

Massage can help increase circulation and lymphatic drainage.

Following Up:

Continued medication and surveillance may be required.

Special Considerations:

Pregnant women who are obese and have high blood pressure are at increased risk for pulmonary edema. Patients with heart failure are prone to pulmonary complications, including sleep apnea, pulmonary edema, and pleural effusions.