Pulmonary edema can be manifested by sudden onset of severe breathlessness, rattling breath and coughing attacks.

Causes: What causes pulmonary edema?

The cause of pulmonary edema is either an increase in pressure within the pulmonary vessels or an increase in the permeability of the pulmonary vascular walls. Sometimes combinations of both causes are present.

Cardiac Pulmonary Edema

When the pressure within the vessels increases, it is mostly due to heart disease. One speaks of a cardiac pulmonary edema. For example, a heart attack, an inflammation of the heart muscle, a disease of the coronary vessels or too high a blood pressure in pre-existing heart failure underlying.

These diseases weaken the left ventricle. As a result, they can not pump the oxygen-rich blood provided by the lungs fast enough into the body. The blood builds up in the pulmonary vein. The congestion increases the pressure on the blood vessels. As a result, blood fluid escapes from the vessels and is forced into the lung tissue. The walls of the blood vessels work like filters and allow only the liquid to pass.

The remaining blood components, such as red blood cells or other cells, are held back. The fluid first accumulates in the interstices of the cells and can then penetrate into the interior of the alveoli. As a result, they can perform their task increasingly poorly and oxygen uptake is becoming increasingly difficult.

Altitude Pulmonary Edema

A special feature of the pulmonary edema was the so-called high-altitude edema. It is triggered in mountain climbing at high altitude in the first two to three days by a combination of oxygen deficiency and low air pressure. The vessels contract and cause an increase in blood pressure, which overloads the left ventricle and creates a backlog.

Non-cardiac pulmonary edema

In non-cardiac pulmonary edema, the most common cause is damage to the membranes of the fine pulmonary capillaries. As a result, they lose part of their barrier function; blood fluid, together with smaller cell components, can penetrate into the tissue of the lung. The more effective the lymphatic vessels can initially remove the excess fluid, the slower the development of symptoms.

In most cases, ARDS (Acute Respiratory Distress Syndrome) is the cause of membrane damage. In this case, the lungs react to massive damage, for example from infections with viruses, inhalation of toxic gases, medication, severe burns, serious cardiovascular shock or blood poisoning. Rarely, pulmonary embolism, overdose in anesthesia, or stroke can increase membrane permeability.

“Another cause is damage to the liver and kidneys, which leads to a drop in albumin in the blood – a specific blood protein,” says K√∂hler. Due to the lack of protein, the blood fluid cannot be kept in the necessary amount in the blood vessels and thus reaches the cell gap to the outside.

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Diagnosis

For diagnosis, the doctor asks questions about the underlying and concomitant diseases of the heart, lungs and other organs. When listening to the lungs with the stethoscope rattling noises fall on, which sometimes are already audible with the naked ear. An x-ray examination can be used to determine whether water is actually in the lungs. Important indications for pulmonary edema include accelerated breathing, increased heart rate and blueing of the skin and mucous membranes. An ECG, echocardiography and other examinations target the underlying cause.

Therapy: How is pulmonary edema treated?

Pulmonary edema is a serious, potentially life-threatening condition requiring intensive medical treatment. Patients should be transported to the hospital as soon as possible. As a first measure, an upper body and lower legs are helpful. As a result, the blood flows back to the heart slower, so this is relieved.

Breathing can be assisted by the delivery of oxygen via a nasogastric tube or a mask. In an advanced stage, positive pressure ventilation, in some cases artificial respiration is necessary. Most patients are supplied with painkillers and tranquilizers.

Dehydrating medications (diuretics) ensure that the water drains from the tissue. This not only improves the oxygen exchange at the alveoli but also relieves the blood pressure by reducing the volume of fluid and thus reduces the burden on the heart. Drugs that dilate the vessels lower the pressure on the heart, improving the oxygen supply.

All other measures depend on the underlying cause. In case of height elevation edema, sufferers should descend as soon as possible. In addition, oxygen delivery, vasodilating drugs, and positive pressure ventilation may help.

Persistent coughing with sputum indicates chronic bronchitis. Smoking is the most important risk factor. Those who ignore the signs risk serious lung disease.

In short, what is chronic bronchitis?

Chronic bronchitis means that the bronchi are permanently inflamed. According to the World Health Organization (WHO), bronchitis is considered to be chronic if the symptoms of cough and sputum persist for two consecutive years for at least three months each year.

The bronchi are the continuation of the trachea. It divides into two main bronchi at the lower end. These lead the breathing air into the two lungs. There, the bronchi branch out ever finer until they end in the microscopic small alveoli, where the actual gas exchange, ie the vital intake of oxygen and release of carbon dioxide takes place.

Approximately ten percent of the population suffers from chronic bronchitis during their lifetime. Smoking is considered the biggest risk factor (colloquially “smoker’s cough”), but there are also many other triggers, which is why a reduction in smoking behavior falls short.

The most important therapy measure for smokers is the smoke stop. Various medications, adapted sports and special breathing techniques can help additionally.

Chronic bronchitis can lead to COPD – a chronic obstructive pulmonary disease. The airways are then permanently constricted and alveoli are broken down (emphysema).

Causes and risk factors: How does chronic bronchitis develop?

Risk of tobacco smoke: Smoking is the leading cause of chronic bronchitis. Tobacco smoke damages the respiratory tract in different ways: First, it destroys the cilia in the bronchial mucosa. These normally transport mucus and pollutant particles contained therein and thus exercise a cleaning function. On the other hand, tobacco smoke promotes inflammatory processes, weakens the immune system and causes more mucus to be formed in the bronchi. Especially at night while lying down secretions accumulate, which leads to a morning cough with sputum. Passive smoking also increases the risk of chronic bronchitis.

Air pollutants: Certain gases, dusts, and vapors pollute some people in the workplace. These pollutants can also cause lung problems and cause chronic bronchitis.

Common respiratory infections: Bacterial and viral infections are more common in chronic bronchitis. It often remains unclear whether they are the cause or the consequence of the respiratory disease.

Genetic causes: A certain genetic component can be identified in chronic bronchitis and its consequences. Alpha-1-antitrypsin deficiency, which increases the risk of pulmonary emphysema and may be associated with symptoms of chronic bronchitis, cystic fibrosis, where lung involvement often begins as chronic bronchitis, and ciliary disorder, in which mutations are either missing or defective, are well-characterized Formation of the cilia on the bronchial mucosa leads.

Other underlying diseases: Certain diseases are associated with chronic bronchitis. It is usually hard to recognize cause and impact. Examples are asthma, chronic sinusitis, and pulmonary tuberculosis. A hyperreactive bronchial system, as is typical in people with an allergy, may in rare cases favor chronic bronchitis.

Is chronic bronchitis contagious?

Chronic bronchitis is not intrinsically contagious – unlike acute bronchitis, which is often the case. If respiratory tract infections occur as part of chronic bronchitis, they can be contagious.

Symptoms: How is chronic bronchitis noticeable?

The classic symptom of chronic bronchitis is coughing with expectoration of viscous mucus. The cough occurs, especially in the morning.

Chronic bronchitis often begins insidiously and may initially go unnoticed. Because a clogged cough that lasts for a long time, sufferers often lead back to a supposedly harmless, perhaps “abducted” cold. They do not take the symptom seriously.

Chronic bronchitis can be fluent in COPD. If there is shortness of breath and tightness of the chest during physical exertion, this is a possible sign that COPD has already developed. However, there may be other causes behind such symptoms, such as angina pectoris.

Everything-About-Chronic-Bronchitis

When is a bronchitis chronic?

According to the WHO definition, it is chronic bronchitis if the symptoms of coughing and expectoration occur for two consecutive years for at least three months a year most days of the week.

What is an exacerbation?

Doctors speak of an exacerbation when the patient’s complaints suddenly worsen. This occurs especially in advanced disease and during the cold season. In the majority of cases, respiratory infections are the trigger. If very severe COPD is present, an exacerbation can be life-threatening.

Important: Take respiratory symptoms seriously. See the doctor if symptoms persist like coughing persistently or if shortness of breath occurs.

Chronic bronchitis: What are the consequences of the disease?

Definition

Pulmonary embolism refers to the obstruction or fixing of blood clots (thromboses) in blood vessels of the lungs. Of the entrained blood clots, which are usually transported by the leg veins through the heart, the lungs are often affected. The blood clots in the arterial blood vessels (blood arterial embolism) of the lungs lead to blood and nutrient deficits in the affected blood vessels.

Root Cause

Risk groups, such as people with congenital blood clotting system disorders or people who are immobile, as well as those who are freshly operated, tend to thromboses and thus to embolisms. Obesity, smoking, birth control pills and certain medications can increase the risk of thrombosis. In some cases, blood clots that have formed in the heart may be responsible for pulmonary embolism.

Symptoms

Depending on the size of the blood clot, different symptoms may appear at different intervals. If the blood clot is small, it usually comes only to an atypical cough. Severe pulmonary embolism may include chest pain, shortness of breath, coughing (blood), sweating or anxiety. Also typical are the bluish discoloration of the skin, fingernails or lips, due to the lack of oxygen.

Diagnosis

After a detailed conversation on the history of the disease, special clinical and technical examinations can be carried out, i.a. Blood and oxygen saturation tests, ECG, X-ray and ultrasound examinations, computed tomography and magnetic resonance tomography and nuclear medicine examinations (scintigraphy).

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Therapy

The treatment of pulmonary embolism is usually to be initiated immediately after diagnosis, as this can be life-threatening. Depending on the form of the disease, conservative or surgical therapies may be initiated. Mostly anti-coagulant drugs are used, oxygen therapies initiated and bed rest prescribed. Within the so-called “lysis therapy” special lysis drugs can promote the dissolution of the blood clot. In congenital deficits, such as blood coagulation system damage, the therapy can be used for life or special operations performed.

Prevention

General preventive measures include early mobilization after surgery, avoiding too much bed rest, a healthy diet and lots of exercises. Especially on longer flights, you should make sure that you move the legs (feet) regularly so that it can come to no thrombosis. The airlines are usually familiar with the thrombosis risks on flights and provide information and suggestions. People with an increased risk of thrombosis will find comprehensive advice and preventative treatment at the doctor.

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