• Chest Congestion

Pulmonary Edema: How to Get Rid of Fluid Buildup in the Lungs

Published: May 30, 2025
Updated: June 01, 2025
4 mins

Pulmonary edema is a serious medical condition of the lungs. It can develop gradually or come on suddenly, as in cases of acute pulmonary edema or flash pulmonary edema. Without prompt treatment, it can lead to serious complications. That’s why recognizing the signs early and understanding what pulmonary edema is can be life-saving. 

What is Pulmonary Edema?

Pulmonary edema occurs when fluid builds up in the air sacs (alveoli) of the lungs, making it difficult to breathe. This fluid accumulation prevents oxygen from passing efficiently into the bloodstream, leading to shortness of breath and a feeling of suffocation.

Under normal conditions, oxygen moves from the air into the bloodstream through the thin walls of the alveoli. However, when fluid accumulates in these sacs – either from pressure buildup or other factors – oxygen cannot efficiently pass through. 

This fluid may come from the bloodstream due to increased pressure in the blood vessels of the lungs (as seen in heart failure) or from leakage due to injury or infection in the lungs. As a result, the lungs become less effective at delivering oxygen to the body, and carbon dioxide is less efficiently removed. 

What are the Different Classifications of Pulmonary Edema? 

Each type of pulmonary edema presents its own challenges, but all of them impair the lungs' ability to provide oxygen to the body and require prompt diagnosis and treatment.

Acute pulmonary edema

This is a rapid onset of fluid accumulation, often caused by severe heart conditions like a heart or heart failure. It requires immediate medical attention and can lead to life-threatening respiratory distress within hours or even minutes.

Chronic pulmonary edema

Unlike acute cases, chronic pulmonary edema develops over time, often due to long-standing heart disease or kidney failure. Symptoms may be less intense initially but can gradually worsen, leading to difficulty breathing over weeks or months.

Flash pulmonary edema

A particularly severe and sudden form of pulmonary edema, flash pulmonary edema occurs quickly, often within minutes to hours. It can be triggered by events like a heart attack, severe infection, or high blood pressure, and requires urgent medical intervention to prevent complications such as respiratory failure.

Common Pulmonary Edema Causes

The condition can arise from a variety of medical issues, each affecting the lungs or heart's ability to manage fluid properly. Here are the most common causes of pulmonary edema.

Heart attack or congestive heart failure (CHF)

One of the most frequent pulmonary edema causes, a heart attack or congestive heart failure can lead to fluid buildup in the lungs. In heart failure, the heart's ability to pump blood efficiently is compromised, causing blood to back up in the veins and increase pressure in the lungs. This pressure forces fluid into the alveoli, impairing gas exchange and causing breathing difficulty.

High blood pressure (hypertension)

Chronic high blood pressure can weaken the heart over time, leading to heart failure. The elevated pressure damages the blood vessels in the lungs, making it easier for fluid to leak into the air sacs. This is a significant factor in the development of pulmonary edema, especially in people with untreated or poorly controlled hypertension.

Pneumonia and other infections

Pneumonia and other respiratory infections can lead to pulmonary edema by causing inflammation in the lungs. The infection disrupts normal fluid balance, making it easier for fluid to accumulate in the alveoli. This can complicate breathing and lead to severe respiratory distress if left untreated.

Sepsis and systemic inflammation

Sepsis – which is an infection that spreads throughout the body – can lead to pulmonary edema due to widespread inflammation. In this case, the body's response to infection increases permeability in blood vessels, including those in the lungs, leading to fluid leakage. This can quickly impair oxygenation and require urgent treatment.

Kidney failure

When the kidneys are unable to filter excess fluids and waste from the body, fluid can accumulate in various tissues, including the lungs. Pulmonary edema caused by kidney failure is often the result of a buildup of fluid in the body due to poor kidney function, which the body cannot eliminate efficiently.

Lung injury or trauma

Physical trauma or injury to the lungs – such as from a car accident, smoke inhalation, or inhaling toxic chemicals – can damage the lung tissue, increasing fluid leakage. This can lead to both pulmonary edema and other complications, requiring immediate medical attention. 

High altitude exposure

High-altitude pulmonary edema (HAPE) occurs when individuals travel to high altitudes too quickly. The reduced oxygen levels at higher elevations can lead to fluid buildup in the lungs as the body struggles to adapt to the change in pressure and oxygen availability.

Drug overdose or toxin inhalation

Overdose of certain drugs, especially opioids, or exposure to harmful toxins, can cause the blood vessels in the lungs to leak fluid. This is often seen with substances like heroin, cocaine, or inhaled chemicals. The toxicity disrupts normal lung function, leading to pulmonary edema.

Pulmonary Edema Symptoms

Pulmonary edema symptoms can develop suddenly or gradually, depending on the cause and severity. In all cases, the buildup of fluid in the lungs interferes with normal breathing and oxygen exchange, often leading to noticeable and distressing signs. Recognizing the symptoms of pulmonary edema early can help prevent life-threatening complications.

Early symptoms of pulmonary edema include:

• Shortness of breath, especially when lying flat (orthopnea)

• A feeling of needing to gasp for air or rapid breathing

• Wheezing or a bubbling sound in the chest

• A dry, persistent cough that may worsen at night

Some advanced symptoms include:

• Cough producing pink, frothy sputum (a classic sign of fluid in the lungs)

• Chest pain, especially if caused by an underlying heart condition

• Anxiety, restlessness, or confusion due to low oxygen levels

• Sweating, clammy skin, or cold extremities

• Cyanosis, or a bluish tint to the lips, skin, or nails, indicating severe oxygen deficiency

These pulmonary edema symptoms require urgent medical attention – especially if they appear suddenly, as in acute or flash pulmonary edema. Left untreated, fluid buildup in the lungs can progress rapidly and may become life-threatening.

Pulmonary Edema Treatment Options

Prompt and appropriate pulmonary edema treatment is essential to relieve symptoms, restore oxygen levels, and address the underlying cause. Treatment often begins with emergency care to stabilize breathing and prevent life-threatening complications, especially in cases of acute or flash pulmonary edema.

In critical situations, immediate goals include improving oxygenation, reducing fluid in the lungs, and supporting heart function. Patients may require hospitalization, especially if symptoms are severe or progress rapidly.

Common pulmonary edema treatments

• Oxygen therapy: Supplemental oxygen is typically the first step in treatment. It helps increase oxygen levels in the blood and reduces the strain on the heart and lungs.

• Diuretics: Often referred to as “water pills,” diuretics like furosemide (Lasix) help the body eliminate excess fluid through urine. This reduces pressure in the lungs and provides relief from shortness of breath.

• Blood pressure control medications: Managing blood pressure is critical, especially if hypertension is a contributing factor. ACE inhibitors, beta-blockers, or calcium channel blockers may be used to lower strain on the heart.

• Vasodilators and inotropes: For patients with heart failure, medications that relax blood vessels (vasodilators) or improve heart pumping strength (inotropes) may be part of the treatment plan. These help reduce fluid buildup and improve circulation.

• Mechanical ventilation: If oxygen levels remain dangerously low or breathing becomes difficult, a ventilator may be needed to support respiration while other treatments take effect.

• Tailored treatments based on the cause: 

  • Antibiotics for pneumonia or lung infections

  • Heart medications for congestive heart failure (CHF) or arrhythmias

  • Dialysis for kidney failure-related fluid overload

  • Anti-inflammatory medications for sepsis or lung injury

A comprehensive pulmonary edema treatment plan often combines multiple strategies to ensure both immediate relief and long-term management. Using the right pulmonary edema medications and therapies for the underlying condition is key to preventing recurrence and improving outcomes.

Preventing Future Episodes of Pulmonary Edema

While emergency care is critical during an active episode, long-term prevention of pulmonary edema focuses on managing the conditions that cause it. With the right care plan, many people can reduce their risk of recurrence and avoid life-threatening complications.

Manage chronic conditions

The most effective prevention strategy is controlling the underlying medical issues that lead to fluid buildup in the lungs. This includes:

• Heart failure: Follow your cardiologist’s recommendations closely and report any new or worsening symptoms.

• High blood pressure: Keep it within a healthy range through medication, diet, and regular checkups.

• Kidney disease or diabetes: These can contribute to fluid retention and need consistent medical oversight.

Stick to your medications

Adhering to your prescribed pulmonary edema medications – such as diuretics, blood pressure pills, or heart medications – is crucial. Missing doses or stopping medications abruptly can quickly lead to fluid imbalance and new symptoms.

Make lifestyle changes that support heart and lung health

• Limit salt and fluid intake: Excess sodium and fluids can contribute to fluid retention and lung congestion. Your doctor may recommend daily intake targets.

• Maintain a healthy weight: Carrying extra weight puts additional strain on the heart and lungs. Gradual, sustainable weight loss can reduce this burden.

• Avoid high altitudes unless medically cleared: People with heart or lung conditions should take extra precautions before traveling to high elevations, where oxygen levels are lower and the risk of high-altitude pulmonary edema (HAPE) increases.

• Get early treatment for infections: Colds, flu, or pneumonia can worsen heart and lung conditions. Don’t ignore warning signs like fever, chest tightness, or worsening cough.

Routine monitoring – such as keeping track of daily weight, blood pressure, or symptoms – can also help catch early warning signs before they escalate. With proper care and vigilance, many people can manage their condition and significantly reduce the risk of future pulmonary edema episodes.

Where Can I Learn More About Preventing Pulmonary Edema?

If you’re managing a condition like high blood pressure, heart failure, or kidney disease, LifeMD may be able to help. A team of licensed healthcare providers can prescribe and manage medications that reduce your risk of pulmonary edema, while offering personalized support to help you stay on top of chronic conditions. We also provide guidance on lifestyle changes that may help prevent fluid buildup in the lungs.

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