Acute Pulmonary Edema

Acute pulmonary edema develops when abrupt left ventricular dysfunction raises pulmonary venous pressure and fluid moves into the alveoli. The most common precipitants are acute coronary syndrome, hypertensive emergency, arrhythmias and valvular heart disease.

Typical findings include rapidly progressive dyspnea, orthopnea, pink frothy sputum and diffuse pulmonary crackles. Anxiety and diaphoresis are common, and patients feel more comfortable in the upright position.

Early recognition and treatment can substantially reduce mortality. Priorities include adequate oxygenation, reduction of preload and afterload, and prompt management of the underlying cause.