Cardiogenic Pulmonary Edema

Pulmonary edema is a common condition seen in the hospital by respiratory care practitioners. It is important for respiratory care practitioners to have an understanding of the condition itself, along with the skill set to quickly recognize pulmonary edema. It is also important for respiratory care practitioners to stay current on the most effective treatment options available for patients with pulmonary edema. Pulmonary edema is a condition which results from excess fluid in the lungs. This excess fluid then accumulates in the interstitial tissue and the alveoli. This is an issue because the fluid in the alveoli impairs the gas exchange of oxygen and carbon dioxide which takes place between the alveolar-capillary membrane; impairment

According to the Mayo Clinic (2014), cardiogenic pulmonary edema results from elevated pressures within the heart. Pulmonary edema can result when pulmonary venous pressures exceed 25-28 mmHg (Balachandran, 2014). These elevated pressures can lead to pulmonary edema as fluid that is not effectively pumped out into the body becomes backed up and is forced through the capillaries and into the alveoli. Cardiogenic pulmonary edema typically occurs when the left ventricle becomes unable to efficiently pump received blood to the rest of the body. Common causes of cardiogenic pulmonary edema include: “coronary artery disease, cardiomyopathy, heart valve problems, and uncontrolled high blood pressure” (Mayo Clinic,

The narrowing of these arteries can lead to weakening of the left ventricle due to the increased workload; eventually the left ventricle cannot effectively pump, resulting in blood backing up into the lungs. The fluid is then forced into the blood, through the capillaries and into the alveoli; this is known as congestive heart failure (Mayo Clinic, 2014). Another cause of cardiogenic pulmonary edema is cardiomyopathy. Cardiomyopathy also causes a weakening in the ventricles. Unlike coronary artery disease which is a result of the narrowing of the arteries, cardiomyopathy is caused by damage to the cardiac muscle (Mayo Clinic, 2014). This damage can make the heart unable to properly handle sudden demands such as increased heart rate, blood pressure, infection or water retention (Mayo Clinic, 2014). When the heart is unable to handle these sudden demands, fluid backs up into the lungs and collects in the alveolar sacs. A third cause of cardiogenic pulmonary edema is heart valve