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What is Pulmonary Congestion?

By J.M. Willhite
Updated Mar 03, 2024
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Pulmonary congestion, also known as pulmonary edema, is a serious medical condition characterized by the buildup of fluid in an individual’s lungs. Treatment for this potentially life-threatening condition often requires the administration of supplemental oxygen and medication to stabilize the individual’s condition. Complications associated with this condition can include the necessitation of permanent supplemental oxygen and premature death.

Individuals who develop pulmonary congestion may experience a variety of signs and symptoms that may gradually progress to the point of severely impairing one’s ability to breathe without the aid of artificial support. In addition to shortness of breath, individuals may develop a persistent and bloody cough that progressively worsens. The continued accumulation of fluid in one’s lungs often leads to audible respiration demonstrated with wheezing and gurgling when breathing deeply. Additional signs may include pallor, feelings of anxiety, and profuse sweating.

Considered a presentation of the advanced stages of congestive heart failure, pulmonary congestion occurs when the heart is no longer able to adequately support the respiratory system. As the heart fails to pump sufficient blood through the lungs, blood pressure within the lungs increases causing fluid to accumulate in the numerous air sacs, known as alveoli, that normally work to circulate oxygen and help to keep the lungs inflated. The introduction of fluid into the lungs ultimately reduces lung capacity, forcing oxygen out and resulting in shortness of breath. Pulmonary edema may also manifest in the wake of trauma to lung tissue as sustained in the presence of infection or exposure to toxic substances.

Individuals exhibiting signs of this condition may already be under the care of a physician for another condition, such as heart disease. The presence of fluid buildup in the lungs, even during its early stages, possesses an audible presentation, known as rales, when examined with the aid of a stethoscope. Additional signs that may present during a preliminary examination might include elevated heart rate and respiration, known as tachycardia and tachypnea respectively. To confirm a diagnosis of pulmonary edema, additional testing may be performed to rule out the presence of other conditions that may possess symptoms that mimic those associated with pulmonary congestion. Imaging testing may be administered to evaluate the condition of the lower respiratory and cardiovascular systems, including an electrocardiogram (ECG) and chest X-ray.

In order to prevent permanent damage, timely and appropriate treatment is necessary to alleviate symptoms associated with pulmonary congestion. Treatment is often dependent on the cause of the congestion, such as that induced by the occurrence of a heart attack. Once the underlying cause for the congestion is identified and treated, then the congestion may be remedied.

Those with pulmonary edema may be given supplemental oxygen to ease their breathing and, in some cases, a breathing tube may be introduced into the trachea. Diuretics are often administered to alleviate fluid that has accumulated and impaired respiration. If symptoms are left untreated, pulmonary edema may lead to oxygen deprivation-induced organ failure and, ultimately, result in death.

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