Pulmonary Edema: Causes

Pathogenesis (development of disease)

In pulmonary edema, a cardiac cause can be distinguished from a noncardiac cause. Fluid leakage from the pulmonary capillaries (small pulmonary vessels) into the interstitium (intercellular space; interstitial pulmonary edema) and/or alveolar space (intraalveolar pulmonary edema) occurs in pulmonary edema. The cause may be increased pulmonary capillary pressure, decreased colloid osmotic pressure (COD) (also oncotic pressure; pressure exerted by colloids in a solution), and increased permeability (permeability) of the capillaries.

Etiology (causes)

Behavioral causes

  • Drug use

Disease-related causes

Respiratory system (J00-J99)

  • ARDS (adult respiratory distress syndrome) – life-threatening acute damage to the lungs; often associated with multiorgan failure in the setting of SIRS (systemic inflammatory response syndrome; clinical picture resembling sepsis).
  • Pneumonia (pneumonia)
  • Silicosis – lung disease belonging to the pneumoconioses, which is caused by inhalation of quartz dust.
  • Sipe syndrome (Engl. Swimming induced pulmonary edema; swimming-induced pulmonary edema): non-cardiac-related pulmonary edema; symptomatology: Acute onset of acute dyspnea, productive cough (cough in which mucus is brought up from the bronchi or pharynx into the oral cavity), and/or hemoptysis (coughing up blood) during or after swimming, excluding water aspiration; occurs primarily in swimmers and divers; usually over within 24 hoursThe clinical picture is associated with female sex, endurance distances, hypertension (high blood pressure), and smaller lung capacity and lower respiratory flow.
  • Radiation pneumonitis (synonym: radiation pneumonia) – pneumonia secondary to radiotherapy (radiation therapy); interstitial lung disease.

Blood, blood-forming organs – immune system (D50-D90).

  • Disseminated intravascular coagulation (DIC) – acquired blood clotting disorder due to overconsumption of clotting factors and platelets (thrombocytes).

Endocrine, nutritional and metabolic diseases (E00-E90).

  • Hyperthyroidism (hyperthyroidism).
  • Hypothyroidism (underactive thyroid gland)

Cardiovascular system (I00-I99)

  • Aortic dissection (synonym: aneurysm dissecans aortae) – acute splitting (dissection) of the wall layers of the aorta (main artery), with a tear of the inner layer of the vessel wall (intima) and hemorrhage between the intima and the muscular layer of the vessel wall (outer media), in the sense of aneurysm dissecans (pathological expansion of the artery).
  • Endocarditis (inflammation of the inner lining of the heart).
  • Heart failure (cardiac insufficiency), decompensated [most common cause].
  • Cardiac arrhythmias, unspecified
  • Hypertension (high blood pressure)
  • Cardiomyopathy – heart muscle disease leading to impaired heart function; esp. diabetic cardiomyopathy.
  • Valvular vitiation (heart valve defects), unspecified.
  • Coronary artery disease (CAD)
  • Pulmonary embolism – occlusion of one or more pulmonary vessels by an embolus (blood clot), usually based on deep vein thrombosis (DVT).
  • Myocardial infarction (heart attack).
  • Myocarditis (inflammation of the heart muscle)

Infectious and parasitic diseases (A00-B99).

Liver, gallbladder, and bile ducts – Pancreas (pancreas) (K70-K77; K80-K87).

Neoplasms – tumor diseases (C00-D48)

  • Lymphangiosis carcinomatosa – spread of a malignant neoplasm in the lymphatic vessels.

Psyche – nervous system (F00-F99; G00-G99).

  • Neurogenic pulmonary edema – e.g., after traumatic brain injury (TBI), intracranial hemorrhage (bleeding within the skull; parenchymal, subarachnoid, sub- and epidural, and supra- and infratentorial hemorrhage)/intracerebral hemorrhage (ICB; cerebral hemorrhage), or status epilepticus

Pregnancy, childbirth, and puerperium (O00-O99).

Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99).

  • Renal insufficiency (kidney weakness)

Injuries, poisoning, and other consequences of external causes (S00-T98).

  • Anaphylactic shock (allergic shock).
  • Aspiration (swallowing) of gastric juice, fresh, salt water).
  • Pulmonary contusion (pulmonary contusion)
  • Postobstruction pulmonary edema (negative pressure pulmonary edema, NPPE) – pulmonary edema caused by negative pressure; hours may pass after the precipitating event before pulmonary edema manifests itself
  • Traumatic brain injury (TBI).
  • Thoracic trauma – injury to the chest and internal organs.
  • Trauma (injury), unspecified
  • Burns

Other causes

  • High altitude pulmonary edema (HAPE) – fluid accumulation (edema) in the lungs that can occur during mountaineering at high altitudes; at altitudes > 2,000 m, typically occurs during ascent from a lower to a higher altitude; is caused by hypoxic pulmonary vasoconstriction (contraction of the pulmonary vessels due to lack of oxygen); good prognosis with rapid treatment.
  • Cardiopulmonary bypass during surgery (heart-lung machine).
  • Mass transfusion of blood products
  • Postexpansion edema – edema caused by too rapid relief of a pleural effusion (> 1.5 l/day)
  • Reperfusion pulmonary edema – pulmonary edema that may occur after reopening of occluded blood vessels.
  • Negative pressure pulmonary edema – rarely occurs after general anesthesia.
  • Condition after cardioversion – therapeutic procedure in cardiology to restore regular heart rhythm (sinus rhythm) in cardiac arrhythmias.
  • Condition after lung transplantation (LUTX).
  • Condition after pneumectomy (removal of a lung lobe).

Medication

Environmental pollution – intoxications (poisoning).

  • Intoxications with flue gas, chlorine, phosgene, ozone, nitrous gases (nitrogen oxides), etc.