Acute Pulmonary Oedema (1*)

Question 1

What occurs here?

What is its most common cause?
→ How does this lead to pulmonary oedema?

What are its complications?

Answer 1

➊ Excess fluid build-up in the lungs

➋ LV Failure
→ LV is unable to adequately pump blood into circulation, therefore creating congestion in the pulmonary system. This increased pressure pushes fluid out of the vessels.

➌ Pulmonary HTN, Pleural effusion

Question 2

How does it present?

What may be heard O/E?

Answer 2

➊ • Extreme dyspnoea
• Restlessness
• Anxiety
• Cough +/- pink frothy sputum

➋ • Bilateral basal crackles
• 3rd heart sound

Question 3

What investigations should be done?

How is it managed?

Answer 3

➊ • Bloods - BNP, U&Es, Troponin
• CXR
• ECG
• ABG

➋ IVF SOD:
• Stop IVF
• Sit up - fluid falls to lung bases, allowing the upper lungs to work effectively
• Oxygen - be cautious with COPD pts
• Diuretics - IV Furosemide 40mg to reduce overload on heart, making it pump more effectively