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==Overview==
Pulmonary [[edema]] is fluid accumulation in the [[lung]]s. This fluid accumulation leads to impaired gas exchange and [[hypoxia]].


==Differential diagnosis of Underlying Causes of Pulmonary Edema==
Pulmonary edema is either due to direct damage to the tissue or as a result of inadequate functioning of the heart or circulatory system.
===Cardiogenic===
* Severe [[cardiac arrhythmia|arrhythmias]] ([[tachycardia]]/fast heartbeat or [[bradycardia]]/slow heartbeat)
* [[Arteriovenous malformation]]
* [[Anomalous pulmonary venous return]]
* [[Aortic Regurgitation]]
* [[Aortic Stenosis]]
* [[Arrhythmia]]
* [[Cardiomyopathy]]
* Congenita pulmonary venous stenosis
* [[Congestive heart failure]]
* [[Coronary Heart Disease]]
* [[Hypertensive crisis]]
* [[Left Heart Failure]]
* Left-to-Right Shunt
* [[Mitral Regurgitation]]
* [[Mitral Stenosis]]
* [[Myocarditis]]
* [[Pericardial Disease]]. [[Pericardial effusion]] with tamponade
* ST elevation [[MI]] with [[left ventricular failure]]
===Non-cardiogenic===
This form is contiguous with ARDS ([[acute respiratory distress syndrome]]):
* Acute Bronchial [[Asthma]]
* [[Acute Renal Failure]]
* Bacterial toxins
* Blood [[Transfusions]]
* [[Burns]]
* Chronic [[mediastinitis]]
* Decompression sickness
* [[Disseminated Intravascular Coagulation]]
* [[Drowning]]
* [[Drugs]]
* Fibrotic/inflammatory disease
* Fluid overload, e.g. from [[renal failure|kidney failure]]
* Gastric content [[aspiration]]
* [[Goodpasture's Syndrome]]
* [[High altitude sickness]]. Ascent to high altitude occasionally causes [[high altitude pulmonary edema]] (HAPE)<ref>{{cite web | author=M Bates | title=High altitude pulmonary edema| url=http://www.altitude.org/hape_altitude.htm| publisher=Apex (Altitude Physiology Expeditions) | accessdate=2007-03-06}}</ref>
* [[Hyperhydration]]
* [[Hypoalbuminemia]] / Albumin deficiency
* [[Idiopathic Venoocclusive Disease]]
* Inhalation of toxic gases
* [[Infection]]
* [[Leukemia]]
* [[Malaria]]
* Miliary [[Tuberculosis]]
* Neurogenic, e.g. [[subarachnoid hemorrhage]]
* [[Pheochromocytoma]]
* [[Pneumonia]]
* Pulmonary contusion, i.e. high-energy trauma
* [[Pulmonary Embolism]]
* Reexpansion, i.e. post [[pneumonectomy]] or large volume [[thoracentesis]]
* Reperfusion injury, i.e. postpulmonary thromboendartectomy or [[lung transplantation]]
* [[Sepsis]]
* [[Shock]]
* [[Toxic Shock Syndrome]]
* Multi[[trauma]], e.g. motor vehicle accident
* Upper airway obstruction
* [[Uremia]]
===Complete Differential Diagnosis of the Causes of Pulmonary Edema===
(By organ system)
{|style="width:70%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | 
Severe [[cardiac arrhythmia|Arrhythmias]] ([[tachycardia]]/fast heartbeat or [[bradycardia]]/slow heartbeat),[[Arteriovenous malformation]],[[Anomalous pulmonary venous return]], [[Aortic Regurgitation]], [[Aortic Stenosis]], [[Arrhythmia]], [[Cardiomyopathy]], Congenital [[pulmonary vein]] stenosis, [[Congestive heart failure]], [[Coronary Heart Disease]], [[Hypertensive crisis]], [[Left Heart Failure]], Left-to-Right Shunt, [[Mitral Regurgitation]], [[Mitral Stenosis]], [[Myocarditis]], [[Pericardial Disease]], [[Pericardial effusion]] with tamponade, ST elevation [[MI]] with [[left ventricular failure]]
|-
|-bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
|bgcolor="Beige"| 
[[Chemotherapy]]
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| 
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| 
A variety of [[Drugs]], particularly [[Chemotherapeutic agents]] such as anthracyclines
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| 
[[Upper airway obstruction]]
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| 
[[Pheochromocytoma]]
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| 
[[High altitude sickness]]. Ascent to high altitude occasionally causes [[high altitude pulmonary edema]] (HAPE)<ref>{{cite web | author=M Bates | title=High altitude pulmonary edema| url=http://www.altitude.org/hape_altitude.htm| publisher=Apex (Altitude Physiology Expeditions) | accessdate=2007-03-06}}</ref>, Inhalation of toxic gases such as amonia, [[Water intoxication]]
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| 
Gastric content [[aspiration]]
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| 
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| 
Blood [[Transfusions]], [[Idiopathic Venoocclusive Disease]],
[[Disseminated Intravascular Coagulation]], [[Leukemia]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| 
[[Hyperhydration]], Blood [[Transfusions]], [[High altitude sickness]]. Ascent to high altitude occasionally causes [[high altitude pulmonary edema]] (HAPE)<ref>{{cite web | author=M Bates | title=High altitude pulmonary edema| url=http://www.altitude.org/hape_altitude.htm| publisher=Apex (Altitude Physiology Expeditions) | accessdate=2007-03-06}}</ref>
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| 
Bacterial toxins, [[Malaria]], Miliary [[Tuberculosis]], [[Sepsis]], [[Toxic Shock Syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| 
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| 
Neurogenic, e.g. [[Subarachnoid hemorrhage]]
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
|bgcolor="Beige"| 
[[Hypoalbuminemia]] / [[Albumin]] deficiency, [[Water intoxication]]
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| 
[[Toxic Shock Syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| 
[[Chemotherapy]]
|-
|-bgcolor="LightSteelBlue"
| '''Opthalmologic'''
|bgcolor="Beige"| 
|-
|-bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
|bgcolor="Beige"| 
[[Chemotherapy]], [[Water intoxication]]
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| 
[[Psychogenic polydipsia]] with [[hyperhydration]], [[Water intoxication]]
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| 
Acute Bronchial [[Asthma]], [[Drowning]], Gastric content [[aspiration]], [[Mediastinitis]],[[Pneumonia]], [[Pulmonary contusion]], [[Pulmonary embolism]], Reexpansion, i.e. post [[pneumonectomy]] or large volume [[thoracentesis]], Reperfusion injury, i.e. postpulmonary thromboendartectomy or [[lung transplantation]], [[Upper airway obstruction]]
|-
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
|bgcolor="Beige"| 
[[Acute Renal Failure]], [[Uremia]]
|-
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"| 
[[Goodpasture's Syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| 
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| 
[[Drowning]], [[Burns]], Inhalation of toxic gases, [[Pulmonary contusion]], [[Trauma]]
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| 
[[Acute Renal Failure]], [[Uremia]]
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| 
[[Decompression sickness]], [[Shock]]
|-
|}


==References==
==References==

Revision as of 01:56, 19 August 2011

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Pulmonary edema is fluid accumulation in the lungs. This fluid accumulation leads to impaired gas exchange and hypoxia.


Differential diagnosis of Underlying Causes of Pulmonary Edema

Pulmonary edema is either due to direct damage to the tissue or as a result of inadequate functioning of the heart or circulatory system.

Cardiogenic

Non-cardiogenic

This form is contiguous with ARDS (acute respiratory distress syndrome):

Complete Differential Diagnosis of the Causes of Pulmonary Edema

(By organ system)

Cardiovascular

Severe Arrhythmias (tachycardia/fast heartbeat or bradycardia/slow heartbeat),Arteriovenous malformation,Anomalous pulmonary venous return, Aortic Regurgitation, Aortic Stenosis, Arrhythmia, Cardiomyopathy, Congenital pulmonary vein stenosis, Congestive heart failure, Coronary Heart Disease, Hypertensive crisis, Left Heart Failure, Left-to-Right Shunt, Mitral Regurgitation, Mitral Stenosis, Myocarditis, Pericardial Disease, Pericardial effusion with tamponade, ST elevation MI with left ventricular failure

Chemical / poisoning

Chemotherapy

Dermatologic
Drug Side Effect

A variety of Drugs, particularly Chemotherapeutic agents such as anthracyclines

Ear Nose Throat

Upper airway obstruction

Endocrine

Pheochromocytoma

Environmental

High altitude sickness. Ascent to high altitude occasionally causes high altitude pulmonary edema (HAPE)[2], Inhalation of toxic gases such as amonia, Water intoxication

Gastroenterologic

Gastric content aspiration

Genetic
Hematologic

Blood Transfusions, Idiopathic Venoocclusive Disease, Disseminated Intravascular Coagulation, Leukemia

Iatrogenic

Hyperhydration, Blood Transfusions, High altitude sickness. Ascent to high altitude occasionally causes high altitude pulmonary edema (HAPE)[3]

Infectious Disease

Bacterial toxins, Malaria, Miliary Tuberculosis, Sepsis, Toxic Shock Syndrome

Musculoskeletal / Ortho
Neurologic

Neurogenic, e.g. Subarachnoid hemorrhage

Nutritional / Metabolic

Hypoalbuminemia / Albumin deficiency, Water intoxication

Obstetric/Gynecologic

Toxic Shock Syndrome

Oncologic

Chemotherapy

Opthalmologic
Overdose / Toxicity

Chemotherapy, Water intoxication

Psychiatric

Psychogenic polydipsia with hyperhydration, Water intoxication

Pulmonary

Acute Bronchial Asthma, Drowning, Gastric content aspiration, Mediastinitis,Pneumonia, Pulmonary contusion, Pulmonary embolism, Reexpansion, i.e. post pneumonectomy or large volume thoracentesis, Reperfusion injury, i.e. postpulmonary thromboendartectomy or lung transplantation, Upper airway obstruction

Renal / Electrolyte

Acute Renal Failure, Uremia

Rheum / Immune / Allergy

Goodpasture's Syndrome

Sexual
Trauma

Drowning, Burns, Inhalation of toxic gases, Pulmonary contusion, Trauma

Urologic

Acute Renal Failure, Uremia

Miscellaneous

Decompression sickness, Shock

References

  1. ↑ M Bates. "High altitude pulmonary edema". Apex (Altitude Physiology Expeditions). Retrieved 2007-03-06.
  2. ↑ M Bates. "High altitude pulmonary edema". Apex (Altitude Physiology Expeditions). Retrieved 2007-03-06.
  3. ↑ M Bates. "High altitude pulmonary edema". Apex (Altitude Physiology Expeditions). Retrieved 2007-03-06.
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