Updated: May 21
Hello All, I am back again after an unexpected break. It’s been a while since I’ve written anything because my grandfather passed away few months back due to a heart condition called pulmonary edema. I had never heard of this condition before (though I have read a lot of health books!), so I decided to learn more about it and educate myself about this mysterious, but seemingly common problem in men above the age of 70.
To piece together what the condition might be, I decided to break down the name itself, starting with each word. The term, “pulmonary”, medically means anything related to the lungs, and specifically the arteries connecting it to the heart. For example, there is a medical condition called pulmonary hypertension: it’s a type of high blood pressure that affects arteries in the lungs and the heart. Another example is pulmonary fibrosis; a name for scarring in the lungs. The term “edema” is broadly used for swelling caused by too much fluid trapped in the body’s tissues. So, contextually in my mind, pulmonary edema is fluid trapped in the lungs, possibly causing the organ to swell. According to Yale Medicine, “Pulmonary Edema is a condition in which too much fluid accumulates in the lungs, interfering with a person’s ability to breathe normally.” Some other names for pulmonary edema that you may hear around the block include lung congestion, lung water, and pulmonary congestion, so keep an eye (or an ear!) out for those!
Have you ever tried holding your breath underwater as long as possible, and feeling like your lungs are going to explode? Well, this is because your air sacs in your lungs are not exchanging the carbon dioxide with oxygen as it should. This is similar, but not nearly as intense, as what patients with pulmonary edema are feeling. It is said that they have the sensation that they are drowning: As more and more fluid is excessively building up in the lungs, it needs a place to go so it is pushed into the lung’s delicate air sacs. These sacs are for holding gas, not liquid, and as expected, it makes it harder to continue breathing normally. Unfortunately, pulmonary edema is an emergency situation because patients are not getting the oxygen they need; the faster they get medical attention, the chances of recovering increase.
According to previous accounts of patients, people with pulmonary edema can experience any or all of the following symptoms/warning signs: shortness of breath/quick and shallow breathing, feelings of anxiety related to breathing difficulties, wheezing, trouble breathing while lying down, a feeling of suffocation, coughed up mucus that can be pink if blood is present, increased heart rate, abnormal heart sounds, crackles in the lungs, sweating, pale/bluish skin, swelling in the feet (this reminded me of the official definition of edema), and even confusion.* Something that intrigued me was that this list is similar to the symptoms for any other heart related problem, such as a heart attack or cholesterol. Another thing I found interesting was that most of these symptoms can even be confused for a common cold. For example, shortness of breath, wheezing, and sweating are all common symptoms for COVID-19. Because of this, could many people have been misdiagnosed and went without medical treatment?
If you are seen in a hospital for pulmonary edema, there isn’t one single test that can diagnose this condition, but doctors can figure out it by looking at there medical history, giving them a physical exam, as well as ordering a series of tests that can check for fluid. Step 1 of the diagnosis process is medical history and this is fairly straightforward. Doctors may ask if you have a history of heart failure or high blood pressure, as well as any past diseases such as kidney disease or pneumonia. * Step 2 is the physical exam, and while it may seem unnecessary, it is the most important aspect of care. Your doctor will listen to your breathing with a stethoscope, checking for crackles (as mentioned earlier). Crackles are sounds that occur when the air sacs are filled with fluid, which can quite accurately predicate if you have pulmonary edema. Step 3 includes running certain diagnostic tests, as well as interpreting the results. These tests do not clearly have a positive/negative result, so they are usually used to rule out other conditions. The most common tests are chest x-rays and electrocardiograms, but there are some more specialized ones that doctors may need to run if they are not confident in their result. For example, blood tests can check certain hormone levels that can point towards any swollen tissue. Another example is a pulmonary capillary wedge pressure test: a catheter (a flexible tube inserted into the tube to remove excess fluid) is inserted into a blood vessel to measure the pressure in the left side of the heart. Although there are multiple treatments and medications to fix this, doctors need to be completely sure about the diagnosis before starting them as to prevent any life-threatening side effects.
One intriguing thing I discovered in my research was that there is a correlation between people with pulmonary edema and their intake of sodium. Although sodium is necessary for the body, too much can be bad for you. It’s scientifically proven that sodium toxicity causes pulmonary edema, and it is also associated with inflammatory immune responses as well as COVID symptoms such as fever and nasal sinus congestion. So, to get all the salt you need, while also keeping your levels under control, it is recommended by FDA that you get a maximum of 1 teaspoon of salt per day, and even less for children. Remember preventing a disease is hands down the best way to treat one!
*For more information or if you are concerned about the health of yourself or a loved one visit cdc.gov or see a medical professional.
Thanks for reading!