Introduction:

Pulmonary edema happens when increased pressure in the blood vessels in your lungs causes them to fill up with fluid, making it hard to breathe. It is often caused by heart disease. It may also be caused by 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 may 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

If pulmonary edema is related to congestive heart failure, symptoms may come on more gradually. You may notice shortness of breath when you' re lying down, quick weight gain (from retaining fluid), and fatigue.

What Causes It?:

The most common cause of pulmonary edema is heart failure. But not every case is due to heart problems. Some risk factors for pulmonary edema include:

• High blood pressure
• Diabetes
• Coronary or valvular heart disease
• Obesity
• Being at high altitude
• Central nervous system injury
• Infection
• Hanta virus
• Inhaling toxins

What to Expect at Your Provider's Office:

Pulmonary edema that happens suddenly 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. If you are in the hospital, you will be given oxygen.

Treatment Options:

Medications may include diuretics (water pills) to get rid of excess fluid in your lungs, blood pressure medication, 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. Complementary and alternative therapies can be used along with conventional care, helping to strengthen your heart and lungs. But they should never be used alone to treat pulmonary edema. Make sure to tell all of your medical providers about 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). With other kinds of diuretics, you may need to make sure you don' t get too much potassium. Ask your doctor if you need more magnesium and potassium.

• Coenzyme Q10 (100 mg two times per day) is good for heart health. Several research studies suggest that CoQ10 supplements can help reduce swelling in the legs, enhance breathing by reducing fluid in the lungs, and increase exercise capacity in people with heart failure. Not all studies agree, however. If you take blood-thinning medication (anticoagulants), ask your doctor before taking CoQ10.
• L-carnitine (500 mg three times per day) improves endurance and is good for heart health. Carnitine is a nutrient that helps the body convert fatty acids into energy, which is then used primarily by your muscles. If you take blood-thinning medication (anticoagulants) or thyroid hormone, ask your doctor before taking carnitine.
• Magnesium (200 mg two to three times per day) helps your heart work efficiently and may help treat congestive heart failure. In addition, some diuretics (water pills) may cause your body to lose too much magnesium. For this reason, your doctor may recommend a supplement. Magnesium and calcium work together to help your heart function, so it' s important to ask your doctor before taking either magnesium or calcium supplements. Both interact with several medications, herbs, and supplements as well.
• Potassium helps heart muscle to contract. Depending on the type of diuretic you take, your doctor may recommend taking a potassium supplement. The dose will depend on the level of potassium in your blood, so your doctor will determine the proper amount. However, with other kinds of diuretics taking a potassium supplement might cause you to get too much potassium. Ask your doctor before taking extra potassium.
• Vitamin E (400 IU per day) and vitamin C (1,000 - 1,500 mg per day) are antioxidants that may promote heart health, although evidence is mixed.
• Thiamin (vitamin B1, 200 mg per day) may improve cardiac function in people with heart failure, although studies show mixed results. In addition, diuretics (water pills) can cause your body to lose too much thiamine. Talk to your doctor about measuring your level of vitamin B1 and whether you should take thiamine.
• L-arginine (6 g per day) and taurine (1,000 mg twice a day), which are amino acids, may improve heart function in people with heart failure. Be sure to ask your doctor before taking l-arginine, because it may interfere with other treatments and may not be right for you.

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.

Ask your doctor before taking herbs for pulmonary edema.

For pulmonary edema that does not originate with the heart:

• Garlic (Allium sativum), 1,000 - 4,000 mg per day, helps you cough up mucus, may slightly lower blood pressure, and stimulates your immune system. Garlic may increase the risk of bleeding, especially if you take blood-thinning medication (anticoagulants). If you take blood thinners such as warfarin (Coumadin), ask your doctor before taking garlic.
• Rosemary (Rosmarinus officinalis), 1 cup tea three times per day. May help the body get rid of excess fluid. To make tea, steep 1 - 2 g of rosemary leaves in one cup boiling water. Strain and cool. Do not take rosemary if you take diuretics (water pills).
• 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.
• Horse chestnut (Aesculus hippocastanum), 250 mg two times per day, standardized for aescin content, may help the body get rid of excess fluid. 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 (anticoagulants), and do not exceed recommended dosage.
• Horsetail (Equisetum arvense) is traditionally used as a diuretic to help the body get rid of excess fluid. 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.

For pulmonary edema originating with the heart, especially heart failure, the following herbs may help. It is important to get a diagnosis from your doctor concerning the type of heart disease, so you will know which herbs may be right for your condition.

• Hawthorn (Crataegus monogyna), 240 - 600 mg per day. Hawthorn is used in many types of heart disease. Several scientific studies suggest that hawthorn improves the heart' s ability to pump blood in people with heart failure. It also significantly improved symptoms (like reduced shortness of breath and fatigue) and helped people exercise longer.
• Linden (Tilia cordata), 1 - 2 cups tea per day. May help the body get rid of excess fluid. To make tea, steep 2 g in one cup boiling water. Strain and cool. Do not take linden if you take diuretics (water pills).
• Asian ginseng (Panax ginseng), 200 - 600 mg per day, may act as a diuretic. Do not take ginseng if you take diuretics (water pills).
• Forskohlin (Coleus forskohlii), 50 - 100 mg two to three times a day.
• Astragalus (Astragalus membranaceus) helps the body get rid of excess fluid. The dose should be determined by your doctor. Do not take astragalus if you take diuretics (water pills).
• Ginkgo (Ginkgo biloba), 120 - 240 mg in two or three divided doses per day, may help improve circulation and heart function. Do not take ginkgo if you take blood-thinning medication (anticoagulants) 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.

Being active or exercising helps your body get rid of excess fluid. Ask your doctor about the level of physical activity that would be safe and beneficial for you.

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 heart and lung function.

Massage

Massage can help increase circulation.

Following Up:

If you have congestive heart failure, you will need to work closely with your doctor to manage your symptoms.

Special Considerations:

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