Presentation
Signs of right ventricular (RV) failure (eg, neck vein distention, peripheral edema) may be present. [merckmanuals.com]
Case Presentation A 55-year-old man with a history of congestive heart failure (CHF) and hypertension (HTN) presents with worsening shortness of breath over the last 2 days. [emdocs.net]
Pink, frothy sputum may be present in patients with severe disease. Occasionally, hoarseness may be present as a result of compression of the recurrent laryngeal nerve palsy from an enlarged left atrium, such as in mitral stenosis (Ortner sign). [emedicine.medscape.com]
Moist rales are present (starting at the lung bases and extending to various levels of the lung, depending on the severity of the edema). Coughing may be present and, in fulminant cases, productive of pink frothy sputum. [tele.med.ru]
Entire Body System
- Pain
With pleural effusion, you may experience: breathing difficulties a dry cough shortness of breath chest pain and discomfort A chest x-ray can help diagnose pleural effusion. Your doctor may take a biopsy from pleural tissues if cancer is suspected. [healthline.com]
Symptoms include shortness of breath, cough, decreased exercise tolerance or chest pain. Treatment Pulmonary edema can be acute or chronic. [medicalnewstoday.com]
From Pathology Education Instructional Resource Clinical Summary This 69-year-old white male with well-controlled Type I diabetes mellitus (insulin-dependent) presented with upper abdominal and lower chest pain of four hours duration and accompanied by [peir.path.uab.edu]
(Instructor in Anesthesia, Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts), for reviewing the case scenario and Fumito Ichinose, M.D. [anesthesiology.pubs.asahq.org]
Confusion and lethargy from lack of oxygen delivery to the brain; andangina ( chest pain ) from the heart, can both be associated with massive pulmonary edema and respiratory failure. [emedicinehealth.com]
- Fever
الصفحة 311 - Group of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young of the American Heart Association. الصفحة 63 - Executive summary. [books.google.com]
A 62-year-old man presents with a three-day history of progressive dyspnea, nonproductive cough, and low-grade fever. [nejm.org]
Mitral stenosis is usually a result of rheumatic fever, after which it may gradually cause pulmonary edema. [emedicine.medscape.com]
[…] fatigue High-altitude pulmonary edema Pulmonary edema due to altitude sickness, or not getting enough oxygen in the air, will have symptoms that include: headaches irregular, rapid heartbeat shortness of breath after exertion and during rest coughing fever [healthline.com]
Respiratoric
- Respiratory Distress
FAILURE Sibling Codes J81.0 Acute pulmonary edema Parent Sibling Codes J80 Acute respiratory distress syndrome J81 Pulmonary edema J82 Pulmonary eosinophilia, not elsewhere classified J84 Other interstitial pulmonary diseases J85 Abscess of lung and [rxdb.com]
호흡곤란 동의어 Shortness of breath, Dyspnea, dyspnoea, shortness of breath (SOB), breathlessness, difficulty of breathing, respiratory distress 진료과 호흡기내과 호흡곤란(呼吸困難, dyspnea) 또는 호흡장애(呼吸障礙)는 숨쉬기 어려운 느낌을 말한다. [ko.wikipedia.org]
상병코드 한글상병명 영문상병명 J708 기타 명시된 외부요인에 의한 호흡기 병태 Respiratory conditions due to other specified external agents J709 상세불명의 외부요인에 의한 호흡기 병태 Respiratory conditions due to unspecified external agents J80 성인호흡곤란증후군 Adult respiratory distress syndrome J80 성인유리질막병 [druginfo.co.kr]
So, basically, even if your patient is in mild respiratory distress, this condition can build upon itself and become life threatening in a hurry. Be ready to intubate if the patient's respiratory distress worsens. [medictests.com]
Diagnosis POPE requires rapid intervention and may be confused with other causes of postoperative respiratory distress. [aafp.org]
- Aspiration
A rare form of edema follows rapid aspiration of large pleural effusions and occurs on the side of the aspiration. [histopathology-india.net]
Acute pulmonary edema may occur as the result of conditions other than heart failure, including ARDS (acute respiratory distress syndrome), volume overload with or without pre-existing heart failure, aspiration (as in near-drowning), altitude sickness [acphospitalist.org]
Examples of Non-cardiogenic eiologies include, aspiration, chest trauma, ARDS, sepsis, and pulmonary embolism. [pathwaymedicine.org]
Aspiration pneumonitis can be of increased concern in the prone position given the potential for increased abdominal pressure. [anesthesiology.pubs.asahq.org]
[…] interstitial pressure)의 급격한 감소 기흉의 빠른 배출 천식 임파액 배출의 폐쇄 폐이식후(postlung transplant) Lymphangitic carcinomatosis Fibrosing lymphangitis 급성호흡부전(Adult respiratory distress syndrome) 폐렴 흡입독소(Inhaled toxin) 혈관내 독소(Circulating foreign substances) 뱀독 독소(endotoxin) 흡인(Aspiration [clinicclinic2.cafe24.com]
Cardiovascular
- Palpitations
You may experience: shortness of breath, chest discomfort, heart palpitations, coughing, difficulty walking uphill, fatigue, fever, or headaches. [lungmds.com]
[…] with breathing difficulties, other signs and symptoms of acute pulmonary edema can include: cough, often with a pink frothy sputum excessive sweating anxiety and restlessness feelings of suffocation pale skin wheezing rapid or irregular heart rhythm (palpitations [medicalnewstoday.com]
Sudden pulmonary edema also may be accompanied by extreme anxiety and palpitations. Sudden-onset pulmonary edema is often called “flash pulmonary edema,” and it most often indicates a sudden worsening of an underlying cardiac problem. [verywellhealth.com]
Sudden pulmonary edema also may be accompanied by extreme anxiety, and palpitations. Sudden-onset pulmonary edema is often called “flash pulmonary edema,” and it most often indicates a sudden worsening of an underlying cardiac problem. [verywell.com]
[…] drowning that worsens when lying down Wheezing or gasping for breath Cold, clammy skin Anxiety, restlessness or a sense of apprehension A cough that produces frothy sputum that may be tinged with blood Blue-tinged lips A rapid, irregular heartbeat (palpitations [drugs.com]
Psychiatrical
- Hunger
[…] arteries that bring blood to the kidneys Lung damage caused by poisonous gas or severe infection Major injury Symptoms of pulmonary edema may include: Coughing up blood or bloody froth Difficulty breathing when lying down (orthopnea) Feeling of "air hunger [medlineplus.gov]
Patients may be sitting upright, they may demonstrate air hunger, and they may become agitated and confused. Patients usually appear anxious and diaphoretic. Hypertension is often present, because of the hyperadrenergic state. [emedicine.medscape.com]
Neurologic
- Stroke
Furthermore, if it is chronic, then there is a stroke risk. 2. Slow the rate with an AV nodal blocker? Diltiazem? Esmolol? This will not restore the atrial contribution, but will slow the ventricular rate and allow for more filling. 3. [hqmeded-ecg.blogspot.com]
Lowering cholesterol levels - high cholesterol can lead to fatty deposits in the arteries, which, in turn, increases the risk of heart attack and stroke and therefore pulmonary edema. [medicalnewstoday.com]
The hemodynamic effects of ACE inhibitors include reduced afterload, improved stroke volume and cardiac output, and a slight reduction in preload. [emedicine.medscape.com]
Workup
X-Ray
- Pericardial Effusion
On the left another patient with a large cardiac silhouette on the chest x-ray due to pericardial effusion. Pericardial effusion is demonstrated on the coronal CT-reconstruction. [radiologyassistant.nl]
Pericardial effusion with tamponade - a buildup of fluid around the sac that covers the heart. This can decrease the heart's ability to pump. Severe arrhythmias - this can be tachycardia (fast heartbeat) or bradycardia (slow heartbeat). [medicalnewstoday.com]
The test can help diagnose a number of heart problems, including heart valve problems, abnormal motions of the ventricular walls, fluid around the heart (pericardial effusion) and congenital heart defects. [drugs.com]
Hypertrophy
- Ventricular Hypertrophy
Critical Essential Core Tested Community Questions (2) Sorry, this question is for PEAK Premium Subscribers only (M1.PL.102) A 65-year-old male with a past medical history of left ventricular hypertrophy presents to the emergency room because of a history [medbullets.com]
The myocardium is very thick (concentric ventricular hypertrophy) There is very little ventricular filling, and thus very little cardiac output. There is good LV function There were many B lines and a very filled inferior vena cava. [hqmeded-ecg.blogspot.com]
Cardiac monitor and 12 Lead - You will typically see signs of Left Ventricular Hypertrophy on a 12 lead, but CHF can result in a myriad of dysrhythmias you may need to manage as well. [medictests.com]
Electrocardiogram on admission day shows atrial fibrillation with slow ventricular response and left ventricular hypertrophy. Anti-hypertensives and systolic blood pressure. [jsms.sch.ac.kr]
An electrocardiogram ( EKG ) may be helpful in diagnosing heart rhythm disturbances, previous heart attack, and ventricular hypertrophy (thickening of the heart ventricle muscle) associated with hypertension. [emedicinehealth.com]
Treatment
Medscape: "Cardiogenic Pulmonary Edema Treatment & Management." [webmd.com]
الصفحة 188 - The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. [books.google.com]
In these cases, dobutamine is usually first-line treatment. [nps.org.au]
If you have a moderate case and receive quick treatment, you will often have a full recovery. Severe cases can be fatal if you delay treatment. [healthline.com]
2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. [amge.it]
Prognosis
Outlook The outlook (prognosis) depends on the cause of the pulmonary oedema. Pulmonary oedema may get better, either quickly or slowly. However, it can also be life-threatening, especially without urgent medical treatment. [patient.info]
[…] arterial hypoxaemia, and decreased diffusing capacity. 18– 20 Retention of carbon dioxide not previously associated with chronic obstructive pulmonary disease is a common finding in patients presenting with CPO 6, 11, 20– 22 and is associated with a poor prognosis [pmj.bmj.com]
What Is the Prognosis for Pulmonary Edema? Cardiogenic pulmonary edema affects up to 2% of the US population and accounts for hundreds of thousands of hospital admissions. [emedicinehealth.com]
Long-term prognosis of acute pulmonary oedema--an ominous outcome. Eur J Heart Fail 2000;2:137-44. Messerli FH, Bangalore S, Makani H, Rimoldi SF, Allemann Y, White CJ, et al. [nps.org.au]
[…] carcinomatosis Fibrosing lymphangitis (e.g., silicosis) Unknown or incompletely understood High-altitude pulmonary edema Neurogenic pulmonary edema Narcotic overdose Pulmonary embolism Eclampsia After cardioversion After anesthesia After cardiopulmonary bypass Prognosis [aafp.org]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Abstract Electron microscopic studies on the alveolar-capillary barrier were carried out in 13 patients of chronic pulmonary edema and/or congestion resulting from heart disease of various etiologies. [ncbi.nlm.nih.gov]
According to the etiology, edema may be localized (in inflammation or in impaired venous drainage) or systemic (in right heart failure or in nephrotic syndrome). A generalized and severe edema is called anasarca. [pathologyatlas.ro]
[…] manifestations due to the underlying etiology. [icd10data.com]
Below we discuss the basic pathogenesis of pulmonary edema along with possible etiologies and then detail the important clinical consequences of this pathology. [pathwaymedicine.org]
Epidemiology
Epidemiology The overall incidence rate is reported to be around 10% of cases of pulmonary emboli 4,6. Pathology One of the proposed mechanisms is a redirection of blood to uninvolved areas during occlusion of the pulmonary arterial bed 4. [radiopaedia.org]
Epidemiology, pathophysiology, and in-hospital management of pulmonary edema: data from the Romanian Acute Heart Failure Syndromes registry. J Cardiovasc Med (Hagerstown). 2016 Feb. 17(2):92-104. [Medline]. [emedicine.medscape.com]
The current literature regarding its epidemiology is sparse. [anesthesiology.pubs.asahq.org]
Epidemiology of acute heart failure syndromes. Heart Fail Rev. 2007;12:91-5. Medline 6. Cotter G, Metra M, Milo-Cotter O, Dittrich HC, Gheorghiade M. [revespcardiol.org]
Pathophysiology
One method of classifying pulmonary edema is as four main categories on the basis of pathophysiology which include: increased hydrostatic pressure edema two pathophysiological and radiological phases are recognized in the development of pressure edema [radiopaedia.org]
The continued central role these drugs play highlights a lack of understanding of the underlying pathophysiology of the disease. Pathophysiology of APE In the 1940s the cardiorenal model was first put forward as the predominant explanation for APE. [emdocs.net]
In conclusion, pulmonary congestion in AHF is a complex pathophysiologic process, beyond fluid overload and hemodynamics. [revespcardiol.org]
Heart failure: pathophysiology and diagnosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 58. Updated by: Michael A. [medlineplus.gov]
The pathophysiology for the formation of pulmonary edema is similar to that of edema formation in the subcutaneous tissues. [tele.med.ru]
Prevention
The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med 2000 342, 145-53. [books.google.com]
0% Emergent - ED Care Needed - Preventable/Avoidable - 0% Emergent - ED Care Needed - Not Preventable/Avoidable - 100% Primary diagnosis of injury 0% Primary diagnosis of mental health problems 0% Primary diagnosis of substance abuse 0% Primary diagnosis [codelay.com]
Pneumonia requires immediate treatment to prevent complications, which may require antibiotics and oxygen therapy. [healthline.com]
Low levels of BNP ( [2] Prevention [ edit ] In those with underlying heart disease, effective control of congestive symptoms prevents pulmonary edema. [ citation needed ] Dexamethasone is in widespread use for the prevention of high altitude pulmonary [en.wikipedia.org]
Low levels of BNP ( [2] Prevention In those with underlying heart disease, effective control of congestive symptoms prevents pulmonary edema. Dexamethasone is in widespread use for the prevention of high altitude pulmonary edema. [ipfs.io]