What is the Difference Between Cardiogenic and Noncardiogenic Pulmonary Edema

The key difference between cardiogenic and noncardiogenic pulmonary edema is that cardiogenic pulmonary edema happens when there is a left-sided congestive heart failure, while noncardiogenic pulmonary edema can be caused by drowning, fluid overload, aspiration, inhalation injury, neurogenic pulmonary edema, acute kidney disease, allergic reaction, and adult respiratory distress syndrome.

Pulmonary edema is a medical condition due to too much fluid in the lungs. This fluid accumulates in many air sacs in the lungs, ultimately leading to difficulties in breathing. In most instances, heart problems cause pulmonary edema. Therefore, cardiogenic and noncardiogenic pulmonary edema are two different types of pulmonary edema.

CONTENTS

1. Overview and Key Difference
2. What is Cardiogenic Pulmonary Edema
3. What is Noncardiogenic Pulmonary Edema
4. Similarities – Cardiogenic and Noncardiogenic Pulmonary Edema
5. Cardiogenic vs. Noncardiogenic Pulmonary Edema in Tabular Form
6. Summary – Cardiogenic vs. Noncardiogenic Pulmonary Edema

What is Cardiogenic Pulmonary Edema?

Cardiogenic pulmonary edema is caused by increased pressures in the heart due to heart failure. When the overworked left lower heart chamber or left ventricle can’t pump out enough of the blood it gets from the lungs, the pressure in the heart goes up. This increased pressure pushes fluid through the blood vessel walls into the air sacs called alveoli in the lungs. Coronary artery disease, cardiomyopathy, hypertension, heart valve problems, other heart problems, kidney disease, and chronic health conditions such as thyroid disease, hemochromatosis, or amyloidosis are the triggers of this disease. Moreover, the symptoms of this condition may include difficulty breathing when exerting oneself or lying down, shortness of breath, swelling of the legs, tiredness, and a weight increase of more than two pounds per day.

Cardiogenic pulmonary edema can be diagnosed through physical examination, electrocardiogram (EKG), chest X-ray, echocardiogram, blood tests, and pulmonary arterial catheter test. Furthermore, treatment options for cardiogenic pulmonary edema may include medications such as vasodilators, diuretics, invasive procedures such as percutaneous coronary intervention (PCI), ventricular assist device, heart valve replacement, coronary artery bypass graft and intra-aortic balloon pump (IABP), extracorporeal membrane oxygenation (ECMO), and heart transplant.

What is Noncardiogenic Pulmonary Edema?

Noncardiogenic pulmonary edema is pulmonary edema that is not caused by increased pressures in the heart. It can be caused by drowning, fluid overload, aspiration, inhalation injury, neurogenic pulmonary edema, acute kidney disease, allergic reaction, and adult respiratory distress syndrome. Noncardiogenic pulmonary edema is triggered by acute respiratory distress syndrome, drug reaction or drug overdose, blood clots in the lungs, exposure to certain medications, high altitudes, negative pressure pulmonary edema, nervous system conditions or surgeries, smoke inhalation, and viral illnesses. Moreover, symptoms of this condition may include dyspnea, tachypnea, hypoxia that rapidly progresses into acute respiratory failure, breathing difficulties, fever, and cough with expectoration.

Noncardiogenic pulmonary edema can be diagnosed through health history, physical examination, electrocardiogram, radiographic testing, echocardiography, lung ultrasound, pulmonary artery catheterization, and transpulmonary thermodilution. Furthermore, noncardiogenic pulmonary edema is treated through supportive care and managing the underlying disease process, inhaling nitric oxide, prostacyclin, anti-inflammatory therapy, high-frequency ventilation, and supplemental oxygen.

What are the Similarities Between Cardiogenic and Noncardiogenic Pulmonary Edema?

• Cardiogenic and noncardiogenic pulmonary edema are two different types of pulmonary edema.
• Both types of pulmonary edema lead to fluid accumulation in the air sacs of the lungs.
• Severe breathing difficulties characterize them.
• Both types of pulmonary edema are diagnosed through medical history, physical examination, and blood tests.
• They can be treated by supplementing oxygen, supportive care, and mechanical ventilation.

What is the Difference Between Cardiogenic and Noncardiogenic Pulmonary Edema?

Cardiogenic pulmonary edema is mainly caused by left-sided congestive heart failure, while noncardiogenic pulmonary edema can be caused by drowning, fluid overload, aspiration, inhalation injury, neurogenic pulmonary edema, acute kidney disease, allergic reaction, and adult respiratory distress syndrome. Thus, this is the key difference between cardiogenic and noncardiogenic pulmonary edema. Furthermore, cardiogenic pulmonary edema is triggered by coronary artery disease, cardiomyopathy, hypertension, heart valve problems, other heart problems, kidney disease, and chronic health conditions such as thyroid disease, hemochromatosis, or amyloidosis. On the other hand, noncardiogenic pulmonary edema is triggered by acute respiratory distress syndrome, drug reaction or drug overdose, blood clots in the lungs, exposure to certain medications, high altitudes, negative pressure pulmonary edema, nervous system conditions or surgeries, smoke inhalation, and viral illnesses.

The infographic below presents the differences between cardiogenic and noncardiogenic pulmonary edema in tabular form for side-by-side comparison.

Summary – Cardiogenic vs. Noncardiogenic Pulmonary Edema

Pulmonary edema refers to an abnormal build-up of fluid in the lungs. This build-up of fluid ultimately leads to shortness of breath and other breathing difficulties. It also leads to impaired gas exchange in the alveoli, hypoxemia, and respiratory failure. Cardiogenic pulmonary edema is pulmonary edema caused due to the failure of the heart’s left ventricle to remove oxygenated blood from the pulmonary circulation properly. Noncardiogenic pulmonary edema is pulmonary edema due to an injury to the lung tissue or blood vessels of the lung by other things that cause fluid accumulation. So, this summarizes the difference between cardiogenic and noncardiogenic pulmonary edema.

Reference:

1. Sureka, Binit, et al. “Pulmonary Edema – Cardiogenic or Noncardiogenic?” Journal of Family Medicine and Primary Care, 2015.
2. “Noncardiogenic Pulmonary Edema.” Statpearls – NCBI Bookshelf, 2023.

Image Courtesy:

1. “Pulmonaryedema09” By James Heilman, MD – Own work (CC BY-SA 3.0) via Commons Wikimedia
2. “Histopathology of pulmonary edema” By Kristine Jeffers, Brit Long – Kristine Jeffers, Brit Long (2016-11-22). ED Management of Heart Failure: Pearls and Pitfalls. “emDocs” (CC BY 4.0) via Commons Wikimedia