Abstract
Pulmonary edema can be divided into two categories, cardiogenic and non-cardiogenic. Both of these can be life threatening if not treated on time. One of the main characteristics of this disease is the increased fluid in the interstitial spaces and alveoli in the lungs. Cardiogenic pulmonary edema as the name implies, is cause by heart failure. The most common type of heart failure seen with cardiogenic pulmonary edema is left ventricular failure also known as congestive heart failure (CHF). On the other hand, non-cardiogenic pulmonary edema can be caused by many factors including high altitudes, drugs, inhaled toxins, etc. When a patient has pulmonary edema, some common signs and symptoms include excessive shortness of breath,
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Pulmonary edema is characterized as a restrictive pulmonary disorder. People with pulmonary edema cannot fully fill their lungs with air due to stiffness of the lungs.
Definition
Pulmonary edema happens as a result from excessive movement of fluid from the vascular system to the extravascular system and air spaces of the lungs.1,3-5,7,11 It is generally divided into two main pathogenetic types which are hydrostatic (commonly cardiogenic) and permeability edema, also termed “normal pressure” noncardiogenic.1-3,5,7-8,11Cardiogenic pulmonary edema is caused by increased pressures in the heart. This condition occurs when the left ventricle is not able get out enough of the blood it receives from the lungs (congestive heart failure).1,3,5-7 However, Noncardiogenic, as the name implies, is not caused by the heart. In this condition, fluid may leak from the capillaries in your lungs’ air sacs because the capillaries become more penetrable or leaky, even without the increased pressure that is built from your heart.1,3-5,7-8,11
Etiology Heart failure can be caused by many different types of problems in the heart.1-3,5,7-8,11 We all know that the heart itself is responsible for the movement of fluids in the body. And that if the heart fails to function properly, the whole body can be affected in many ways. Heart failure may affect the right side or the left side of the heart.1-3,7-8,11 Hydrostatic pulmonary edema is known as cardiogenic pulmonary
It results when one or both of these gas-exchanging functions are inadequate . It is not a disease but a symptom of an underlying pathology affecting lung tissue function, 02 delivery, cardiac output, or the baseline metabolic state. It is a condition that occurs because of one or more diseases involving the lungs or other body systems. Symptoms of this is hypoexia and hypercapnia.
When CHF starts to become worse, fluid can start to fill up in a person’s lungs and sometimes even throughout a person’s body. The fluid could cause a person to feel out of breath even while resting, swelling in the legs, ankles, or feet, weight gain, feeling bloated, and coughing, wheezing, and having to use the bathroom more at night. There is also a possibility that CHF can happen all of a sudden. When it starts to happen, it is called sudden heart failure. It will eventually cause congestion from fluid building up in the lungs. Symptoms can start to happen by having severe shortness of breath, an irregular or maybe even a fast heart beat and it may even cause coughing up foamy, pink mucus (Heart-Failure
After a period of time, the heart muscles of the left ventricle begin to weaken. The weakening of the left ventricle will lead to decreased empting of the heart (systolic heart failure) which results in decreased cardiac output again. Since the left ventricle does not empty completely, blood begins to back up into the left atrium and then to the pulmonary circulation thus resulting in pulmonary congestion and dyspnea (Story 2012, 104). If left untreated, the blood will back up and affect the right side of the heart causing biventricular heart failure (both right and left heart failure). In right sided heart failure, the right ventricle weakens and cannot empty completely. This incomplete emptying causes blood to back up into the systemic circulation causing systemic edema (Lewis et al. 2014, 771).
The presence of fluid in the alveolar space could potentially cause the lung capacity to be effected as well.
Hemothorax is a type of pleural effusion in which blood accumulates in the pleural space. The excess fluid can interfere with normal breathing by limiting expansion of the lungs.
Pulmonary hypertension is a lung disorder. The arteries that carry blood from the heart to the lungs become narrowed, making it very hard for the blood to get through the vessels, this then causes the pressure in the arteries to increase more than usual (high blood pressure). Scientists think that the procedure starts with injury to the layer of cells that line the small blood vessels of the lungs.
It includes emphysema, chronic bronchitis, and in some cases asthma (NIH.NHLBI, 2012). Emphysema as stated by American Association for Respiratory Care (AARC) is an abnormal enlargement of air spaces distal to the terminal bronchioles and does occur in the lung parenchyma in COPD patients (AARC, 2011; Rosdahl & Kowalski, 2003).
Pleural effusion is the accumulation of fluid in the pleural space. This may lead to the accumulation of fibrous tissue and the fluid will move towards the dependant area and collapse the adjacent lung.
The client’s secondary diagnosis is community-acquired pneumonia. Typically, immune defense mechanisms, such as the secretion of alveolar macrophages and immunoglobulins A and G, protect the lower airway from infection. Streptococcus pneumoniae, the most common causative agent of community-acquired pneumonia, invades the lungs. The organism triggers an inflammatory response, resulting in increased blood flow and vascular permeability. Neutrophil activation occurs, to surround the kill the invading organism. A combination of the offending organism, neutrophils and fluid from the surrounding blood vessels flood the alveoli, inhibiting normal oxygen transportation. This filling of the alveoli may lead to tachypnea, tachycardia and dyspnea. Further obstruction of airflow and an increased impairment of gas exchange occur as mucous production increases. When
heart problems the damaged of alveoli lead to decrease the amount of oxygen in bloodstream because of that the heat will pump strongly to allow blood to reach the lungs. Emphysema also may increase the pressure on blood vessels that connect the lungs and heart, in addition, it can affect a section, which response for contractile and relaxing of the heart, called cor pulmonale. Moreover, pneumothorax, which called also collapsed lung. At this case,, Lager holes, or giant bullae, it is form when empty spaces is develop. Large holes may be as big as half of the lungs. These giant bullae may burst , as a result, the lung deflation will
A person with left sided heart failure my experience SOB and increased episodes of coughing caused by fluid buildup in the lungs. Pulmonary edema often causes a patient to cough up blood-tinged phlegm. (Cadwallader p. 1143). The PMI is displaced toward the left anterior axillary line, and there is a presence of S3 caused by ventricular filling, and/or S4 resulting from atrial contraction against a noncompliant ventricle. (Schilling-McCann p. 176). The person may have cool, pale skin resulting from peripheral vasoconstriction. Restlessness and confusion is normally due to decreased cardiac output.
The pulmonary vasculature contains arteries and arterioles, which branch in the lungs to create a dense capillary bed to provide blood flow. The pulmonary capillary bed is a high-volume, low-pressure, low-resistance system that delivers blood to and from the lungs via the arterial and venous circulation systems. The right ventricle of the heart is responsible for pumping blood to the pulmonary artery and to the lungs so it can be oxygenated while the left ventricle pumps oxygenated blood to the tissues. Typically, hypertension refers to high blood pressure in the systemic circulation, however, an increase in blood pressure may also occur in pulmonary circulation. The pulmonary artery supplying blood to the lungs can become narrowed,
In the case study it discusses a patient, Mrs. Harris, who is a 72 year old and is complaining of fatigue and swelling in her feet. Mrs. Harris also expresses her concern on the swelling, as some days she is unable to put her shoes on despite proper elevation. She also states walking to her mailbox can be challenging because it causes her to feel more tired and to have shortness of breath, also known as dyspnea. Mrs. Harris is currently taking medication for high blood pressure, hypertension; and is also drinking approximately 8-12 glasses of wine a week. While examining Mrs. Harris it’s clear she is a little overweight and has swollen ankles. Upon listening to Mrs. Harris’s breathing, crackles are heard. Therefore, Mrs. Harris seems to have congestive heart failure.
Acute cardiogenic pulmonary oedema (ACPO) is a life threatening condition requiring rapid emergency care. ACPO occurs as a result of rapid fluid collection in the lungs interstitial and alveolar spaces (Pinto & Kociol, 2018). Consequently, gas exchange and lung compliance diminishes as the lungs are unable to cope with the rapid fluid accumulation (Purvey & Allen, 2017). ACPO is most commonly seen on a background of left ventricular failure which causes reduced cardiac contractility. This results in a lack of forward pressure leading to pooling of blood in the pulmonary vasculature. Left ventricular dysfunction is triggered by a variety of cardiac diseases such as myocardial infarction, chronic heart failure, cardiomyopathy, new onset arrhythmias
Pulmonary Enema can be identified in a PA and lateral chest radiograph, using a horizontal beam which is critical for the projection of air-fluid levels. It appears an increasingly diffuse in radiodensity in the hilar regions, interstitial spaces and the interlobar septa. Clinical indications or signs of the condition (pulmonary edema) include Signs of the condition include a rapid respiratory rate, heaving of the chest and abdomen, intercostal muscle retractions, and cyanosis. To improve the movement of air into and out of the chest, the patient will often sit upright to breathe and resist laying down. (Venes, D, 2005 p. 666 )