Pulmonary edema is an abnormal buildup of fluid in the air sacs of the lungs, which leads to shortness of breath.

Lung congestion; Lung water; Pulmonary congestion

Symptoms of pulmonary edema may include:

• Coughing up blood or bloody froth
• Difficulty breathing when lying down (orthopnea) -- you may notice the need to sleep with your head propped up or use extra pillows
• Feeling of "air hunger" or "drowning" (if this feeling wakes you from sleep and causes you to sit up and try to catch your breath, it's called "paroxysmal nocturnal dyspnea")
• Grunting, gurgling, or wheezing sounds with breathing
• Inability to speak in full sentences because of shortness of breath

Other symptoms may include:

• Anxiety or restlessness
• Decrease in level of alertness (consciousness)
• Leg swelling
• Pale skin
• Sweating (excessive)

Pulmonary edema is almost always treated in the emergency room or hospital, sometimes in an intensive care unit (ICU).

• Oxygen is given through a face mask or tiny plastic tubes are placed in the nose.
• A breathing tube may be placed into the windpipe (trachea) so you can be connected to a breathing machine (ventilator).

The cause of edema should be quickly identified and treated. For example, if a heart attack has caused the condition, it must be treated immediately.

Medications that may be prescribed include:

• Diuretics, which remove excess fluids from the body
• Medicines to strengthen the heart muscle, control the heartbeat, or relieve pressure on the heart

The outlook depends on the cause. The condition may get better quickly or slowly. Some patients may need to use a breathing machine for a long time. If not treated, this condition can be life-threatening.

Go to the emergency room or call 911 if you have breathing problems.

If you have a disease that can lead to pulmonary edema or a weakened heart muscle, take all prescription medications as instructed. Following a healthy diet, one low in salt and fat, can significantly reduce the risk of developing this condition.

Massie BM. Heart failure: pathophysiology and diagnosis. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 58.

Matthay MA, Martin TR. Pulmonary edema and acute lung injury. In: Mason RJ, Broaddus VC, Martin TR, et al. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 55.

McMurray JJV, Pfeffer MA. Heart failure: management and prognosis. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 59.