Acute Lung Edema

"It may occur in patients with severe trauma or malignant hemopathies subject to polychemotherapy guidelines".


Acute pulmonary edema is defined as the clinical picture secondary to acute left ventricular failure or mitral valve stenosis, with the consequent increase in pulmonary capillary pressure and extravasation of fluid into the interstitium and pulmonary alveoli.

The onset of the picture is usually abrupt, often nocturnal. The incidence increases with age.

Any situation that raises pulmonary capillary pressure will cause acute pulmonary edema. The occurrence of pulmonary edema may be secondary to acute myocardial infarction or left-sided heart failure of any origin (hypertensive crisis, heart arrhythmias) or present in chronic or valvular heart disease (mitral stenosis) decompensated (by increased blood pressure, arrhythmias, hypoxemia).

This section should also include pulmonary edema due to fluid overload (or venous congestion syndrome) that occurs in patients who receive, for therapeutic needs, massive amounts of liquids, crystalloids or blood.

Finally, other forms of edema have been described: by severe and sudden obstruction of the main airway or after sudden and massive drainage of a pneumothorax.

What are the symptoms of acute lung edema?

The main symptom is difficulty in breathing (dyspnea), which can appear when doing certain physical exercises or, in more serious cases, at rest. On many occasions, the patient will not tolerate lying down and having to be upright (orthopnea).

Other symptoms are: poor general condition, restlessness, anguish, heavy sweating, cold skin, coughing with coughing sputum, decreased amount of urine, increased heart rate, increased breathing rate with use of the accessory muscles to achieve ventilation, etc.

The most common symptoms are:

  • Difficulty breathing (dyspnea).
  • Orthopnea.
  • Poor general condition.
  • Sweating.
  • Coldness of the skin.

Do you have any of these symptoms?

You may have acute lung edema

How is acute lung edema diagnosed?


The diagnosis of acute lung edema is based primarily on the physical examination of the patient and chest X-ray.

The auscultation of the lungs, in which the so-called wet crackles are heard, is very characteristic in both lung bases.

The chest X-ray is the most useful study for the diagnosis and it will show the presence of liquid in the lung space, sometimes an increase in the size of the heart will also be observed (cardiomegaly).

To complete the diagnosis, an electrocardiogram will be performed, which will help to identify whether there is a basic cardiopathy that has triggered the picture, and a blood and urine test. 

How is acute lung edema treated?

The treatment of this picture has three objectives:

  • Improve pulmonary ventilation through the administration of oxygen and bronchodilator drugs.
  • Decrease venocapillary pressure to try to reduce lung congestion by administering diuretic drugs (which increase the elimination of fluid through the urine) and drugs with dilating action on the veins (which decrease the amount of blood that reaches the heart).
  • Treatment of the causal disease that has triggered the picture.

Where do we treat it?


The Department of Cardiology
of the Clínica Universidad de Navarra

The Department of Cardiology of the Clinica Universidad de Navarra is a center of reference in different diagnostic techniques and coronary treatments.

We have been the first center in Europe to place a pacemaker by means of a catheterization without the need to open the chest, for cases of severe heart failure.

The Cardiology Department of the Clinic collaborates with the Radiology and Cardiac Surgery Departments to achieve a quick and precise diagnosis of the patient.

Imagen de la fachada de consultas de la sede en Pamplona de la Clínica Universidad de Navarra

Why at the Clinica?

  • Specialized Arrhythmia Unit of national reference.
  • Unit of Hemodynamics and Interventionist Cardiology equipped with the best technology.
  • Cardiac Imaging Unit to achieve the highest diagnostic accuracy.

Our team of professionals