Diagnosis
Breathing problems require immediate diagnosis and treatment. A health care provider can base a diagnosis of pulmonary edema on the symptoms and the results of a physical exam and certain tests.
Once the condition is more stable, the provider can ask about medical history, especially a history of cardiovascular or lung disease.
Tests that can help diagnose pulmonary edema or determine the reason for fluid in the lungs include:
Chest X-ray. A chest X-ray can confirm the diagnosis of pulmonary edema and exclude other possible causes of shortness of breath. It's usually the first test done when a health care provider suspects pulmonary edema.
Chest computerized tomography (CT) scan. A chest CT scan gives more details about the condition of the lungs. It can help a provider diagnose or rule out pulmonary edema.
Pulse oximetry. A sensor is attached to a finger or ear. It uses light to determine how much oxygen is in the blood.
Arterial blood gas test. This test measures the amount of oxygen and carbon dioxide in the blood.
B-type natriuretic peptide (BNP) blood test. Increased levels of BNP may signal a heart condition.
Other blood tests. Blood tests to diagnose pulmonary edema and its causes also usually include a complete blood count, metabolic panel to check kidney function and thyroid function test.
Electrocardiogram (ECG or EKG). This painless test detects and records the timing and strength of the heart's signals. It uses small sensors (electrodes) attached to the chest and sometimes to the arms or legs. Wires attach the sensors to a machine, which displays or prints results. An ECG can show signs of heart wall thickening or previous heart attack. A portable ECG device such as a Holter monitor may be used to continuously monitor the heartbeat at home.
Echocardiogram. An echocardiogram uses sound waves (ultrasound) to create pictures of the beating heart. It can identify areas of poor blood flow, heart valve issues and heart muscle that is not working properly. An echocardiogram can help diagnose fluid around the heart (pericardial effusion).
Cardiac catheterization and coronary angiogram. This test may be done if other tests don't show the cause of pulmonary edema, or when there's also chest pain. It helps health care providers see blockages in the heart arteries. A long, flexible tube (catheter) is inserted in a blood vessel, usually in the groin or wrist. It's guided to the heart. Dye flows through the catheter to arteries in the heart. The dye helps the arteries show up more clearly on X-ray images and video.
Ultrasound of the lungs. This painless test uses sound waves to measure blood flow through the lungs. It can quickly reveal signs of fluid buildup and plural effusions.
