09 March 2012

Water in the Lung: What is Pulmonary Edema?


Several weeks ago I received a really really sad news. My friend's husband died of what they called "water in the lung." When I heard news like this, my brain is quick to response, looking for answer why and what cause "water in the lung". Is it because of diet, or lifestyle? I remember my mother use to warn us sisters against taking bath late at night because according to her, it can cause "water in the lung". I must say, I believe that every words until now. But today, I'm going to find out what is the real issues of "water in the lung."

"Water in the lung" medically known as pulmonary edema. It is also known as congestive heart failure. According to Mayo Clinic, pulmonary edema occurs when the blood received from the lung is not able to pump out by the diseased or overworked left ventricle. Fluid may accumulate when pressure increases inside the left atrium and then in the veins and capillaries in your lungs.

Medical conditions that can cause the left ventricle to become weak and eventually fail include:

1. Coronary artery disease.
Over time, the arteries that supply blood to your heart can become narrow from fatty deposits (plaques). When the heart muscle damage by a heart attack, it can no longer pump as well as it should. When the pumping action of your heart is weakened, blood backs up into your lungs, forcing fluid in your blood to pass through the capillary walls into the air sacs.

2. Cardiomyopathy.
Cardiomyopathy is a condition when your heart muscle is damaged by other than blood flow problems. Cardiomyopathy weakens the left ventricle — your heart's main pump. When the left ventricles can't keep up with a hard work like a surge in blood pressure, a faster heartbeat with exertion, or using too much salt that causes water retention or infections, fluid backs up into your lungs.

3. Heart valve problems.
In mitral valve disease or aortic valve disease, the valves that regulate blood flow in the left side of your heart either don't open wide enough (stenosis) or don't close completely (insufficiency). This allows blood to flow backward through the valve. When the valves are narrowed, blood can't flow freely into your heart and pressure in the left ventricle builds up, causing the left ventricle to work harder and harder with each contraction. The left ventricle also dilates to allow more blood flow, but this makes the left ventricle's pumping action less efficient. Because it's working so much harder, the left ventricle eventually thickens, which puts greater stress on the coronary arteries, further weakening the left ventricular muscle.

The increased pressure extends into the left atrium and then to the pulmonary veins, causing fluid to accumulate in your lungs. On the other hand, if the mitral valve leaks, some blood is backwashed toward your lung each time your heart pumps. If the leakage develops suddenly, you may develop sudden and severe pulmonary edema.

4. High blood pressure (hypertension).
Untreated or uncontrolled high blood pressure causes a thickening of the left ventricular muscle, and worsening of coronary artery disease.

5. Noncardiac pulmonary edema
When the heart is not the cause of the problem of pulmonary edema, it's called as noncardiac pulmonary edema. Some factors that can cause noncardiac pulmonary edema are:

  • Lung infections.
  • Pneumonia, for example.

  • Exposure to certain toxins.
  • These include toxins you inhale — such as chlorine or ammonia.

  • Kidney disease.
  • When your kidneys can't remove waste effectively, excess fluid can build up, causing overload pulmonary edema.

  • Smoke inhalation.
  • Smoke from a fire contains chemicals that damage the membrane between the air sacs and the capillaries, allowing fluid to enter your lungs.

  • Adverse drug reaction.
  • Many drugs — ranging from illegal drugs such as heroin and cocaine to aspirin and chemotherapy drugs — are known to cause noncardiac pulmonary edema.

  • Acute respiratory distress syndrome (ARDS).
  • This serious disorder occurs when your lungs suddenly fill with fluid and inflammatory white blood cells.

  • High altitudes.
  • Mountain climbers and people who live in or travel to high-altitude locations run the risk of developing high-altitude pulmonary edema (HAPE). Although the exact cause isn't completely understood, HAPE seems to develop as a result of increased pressure from constriction of the pulmonary capillaries. Without appropriate care, HAPE can be fatal.

  • Near drowning.
  • Inhaling water causes noncardiac pulmonary edema that is reversible with immediate attention.

Having read this article from Mayo Clinic, I am pretty sure that the pulmonary edema my friend's husband (may his soul rest in peace) had encounter was not a result from a late night shower. It is a good knowledge to share it to my mother as well that taking bath late at night is not doing any harm. Just make sure the water is warm enough for the cold night.


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1 comment:

  1. this is exactly the reason why i was admitted to ICU on my first pregnancy...i've been diagnose with accute pulmonary oedema as in cardiomyopathy...i dont realize how bad it is until I read this...tq for the info....

    ReplyDelete

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