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Pulmonary edema - Symptom

Alternative Names

Lung congestion; Lung water; Pulmonary congestion

Symptoms:

Symptoms of pulmonary edema may include:

Coughing up blood or bloody froth
Difficulty breathing when lying down (orthopnea) -- you may need to sleep with your head propped up or use extra pillows
Feeling of "air hunger" or "drowning" (if this occurs suddenly, awakening you from sleep and causing you to sit up and catch your breath, it's called "paroxysmal nocturnal dyspnea")
Grunting, gurgling or wheezing sounds with breathing
Inability to speak in full sentences because of shortness of breath

Other symptoms may include:

Anxiety or restlessness
Leg swelling
Excess sweating
Pale skin
Decrease in level of alertness (consciousness)

Signs and tests:

The health care provider will perform a physical exam and use a stethoscope to listen to the lungs and heart. The following may be detected:

Crackles in the lungs, called rales
Abnormal heart sounds
Increased heart rate (tachycardia)
Pale or blue skin color (pallor or cyanosis)
Rapid breathing (tachypnea)

Possible tests include:

Complete blood count (CBC)
Blood chemistries
Kidney function blood tests
Blood oxygen levels (oximetry or arterial blood gases)
Chest x-ray
Electrocardiogram (ECG) to look for signs of a heart attack or problems with the heart beat
Ultrasound of the heart (echocardiogram) to see if there is a weak heart muscle, leaky or narrow heart valves, or fluid surrounding the heart

Lungs

Respiratory system

Reviewed last on: 5/1/2011
David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA.

References

O'Brien JF, Falk JL. Heart failure. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 79.

Matthay MA, Martin TR. Pulmonary edema and acute lung injury. In: Mason RJ, Broaddus VC, Martin TR, et al. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 55.

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