Acute cardiogenic pulmonary edema--etiological spectrum and precipitating factors

The analysis of the predisposing and precipitating factors encountered in the anamnesis of the patients hospitalized with acute pulmonary oedema, in order to establish some correlations with the evolution and prognosis.

The study included 50 patients, 32 males and 18 females, admitted to the Cardiology I Clinic between 2009 and 2013, diagnosed with acute pulmonary oedema upon admission. The following aspects were investigated: cardiovascular antecedents, prodromal elements of the current episode of acute pulmonary oedema (APE), risk factors and associated co morbidities, previous treatments followed at home as well as the triggering factors of the acute episode.

The main pathology on which the acute pulmonary oedema (APE) episode occurred was represented by: arterial high blood pressure (HBP), dilated cardiomyopathy, ischemic heart disease, valvular heart disease, pre-existing atrial rhythm disorders. The analysis of the factors that precipitated the acute pulmonary oedema episode revealed the following possible triggering conditions: inadequate physical effort on the background of treatment discontinuation, high sodium diet, a prolonged ischemic episode due to inadequate physical effort, rhythm disorder with rapid ventricular response (atrial fibrillation, atrial flutter). In some cases, the risk factors were cumulated.

Acute pulmonary oedema represents a major emergency that requires immediate admission to hospital and rapid treatment in the emergency department concurrent with the identification of the triggering and precipitating factors.