Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Oedema ++ 514 Pulmonary congestion and hypostasis518.4 Acute edema of lung, unspecifiedPT diagnoses/treatment diagnoses that may be associated with respiratory disorders786.05 Shortness of breath780.7 Malaise and fatigue786.0 Dyspnea and respiratory abnormalities ++ J81.0 Acute pulmonary edemaJ81.1 Chronic pulmonary edema ++ 6A: Primary Prevention/Risk Reduction for Cardiovascular/Pulmonary Disorders6B: Impaired Aerobic Capacity/Endurance Associated with Deconditioning6C: Impaired Ventilation, Respiration/Gas Exchange, and Aerobic Capacity/Endurance Associated With Airway Clearance Dysfunction6F: Impaired Ventilation and Respiration/Gas Exchange Associated With Respiratory Failure +++ Description ++ Fluid accumulation in the air sacs/spaces and parenchyma of the lungsRespiratory failureImpaired gas exchangePeripheral edemaShortness of breath/difficulty breathing +++ Essentials of Diagnosis ++ Sudden onset shortness of breath (dyspnea)CyanosisCirculatory dysfunctionCoughing up bloodPleural effusion +++ General Considerations ++ Injury to the lung parenchymaCardiac arrest secondary to lack of oxygen +++ Demographics ++ Elderly, usually associated with heart failure, are most affected +++ Signs and Symptoms ++ Difficulty breathingFatigueCracklesDyspneaExcessive sweatingAnxietyThird heart soundPale skinPink sputumDiaphoresisIncreased heart rate/tachycardiaCyanosisRalesPeripheral edemaWheezingRhonchi +++ Functional Implications ++ Decreased exercise toleranceExercising at high altitude can worsen edemaInability to speak secondary to shortness of breathDisabling dyspnea when performing simple tasks (i.e., arm elevation to reach into cabinet) +++ Possible Contributing Causes ++ Cardiogenic verse non-cardiogenicAcute myocardial infarction, heart attackSeizuresHead traumaKidney failureElectrocutionIschemiaCongestive heart failure (CHF)Valvular regurgitationMitral stenosisOpiod/heroin useIncreased intracerebral pressureSepsisTransfusionExercising at high altitude +++ Differential Diagnosis ++ CHFInfluenzaCystic fibrosisAsthmaGastroesophageal reflux diseaseBronchiectasisKawasaki diseaseBronchitisUpper respiratory tract infectionCentral airway obstructionLung tumorTuberculosis +++ Laboratory Tests ++ Blood test for electrolytesArterial blood gasesLung function testsPulse oximetryAuscultationPercussion of the chest/lungs +++ Imaging ++ Pulmonary capillary wedge pressurePulmonary angiographyChest radiographCTLung ventilation/perfusion scanEchocardiogram ++ Chest x-ray demonstrates interstitial and alveolar edemaCrackle sound with auscultation +++ Medication ++ DiureticMorphine ++ For imaging, x-rayTo pulmonologist, for respiratory assessment ++ Exercise limitationShortness of breathOxygen deprivationLimited endurance capacity ++ Six-minute walk test for mild or non-symptomatic casesBORG Rating of Perceived Exertion (RPE)Monitor vital signs to include lung auscultationsShort-Form 36 Health Survey (SF-36)New York Heart Association Functional Classification scale ++ OxygenRestFluid intakeSmoking cessationPulmonary rehabilitation (PR) to improve exercise capacityInspiratory muscle training (IMT)Exercise (aerobic, strength, flexibility, ... Your Access profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free a profile for additional features.