Understanding "pulmonary edema."

lost someone in my family last night. i was with them as was the rest of the family in the Hospice room. they did a great job, this is not a rant or a blame thread. the END has been coming for some time, so we were sort of prepared.

pulmonary edema brought on by left side congestive heart failure. (?)

i did the Wiki and Google searches, but what i cannot get is why is there suddenly all of this fluid filling the lungs? i sort of understand the lung / blood / air relationship, ( like an intercooler ?) but why would your body effectively let you drown in your own fluids?

why is the body making all of these fluids in the lungs?

the reason why i am trying to get my head around these medical explanations is i am not convinced this is a "easy" way to go. ( Hospice folks did a great job, liquid Morphine was given, blah blah, this is not about blame)

the gurgling and gasping sounds we endured for almost eleven hours leads me to believe my relative was aware of what was going on, but could not express anything to us.

i understand you cannot prevent death, i am not disputing that. it was his time. but i do not know enough of how the heart lungs work to grasp how they failed him.

i do not understand what was broken in the heart that allowed the lungs to fill with fluid. my mechanical mind needs to understand this.

we were there, several of us from the family for 3 days straight. never left him alone. not once. he knew someone was there at least.

i had my hand on his forehead, and his eyes, which had been open the whole time, but rolled up and out of sight, came down and looked at me.
big, kind, blue eyes, that i have always remembered since i was a child .

2 small gasps for air, some clicking sounds in his chest, and he was gone.

i will miss my grandfather very much, but he is now at peace.

 

With the heart failure the heart cannot pump blood out quick enough. So there is backup of blood into the vessels in the lungs. This causes the pressure to rise and the fluid is lost into the tissues, filling the lungs with fluid. This is the definition of congestive heart failure; the lungs get congested with fluids.

It is very often the final event in a cascade of worsening hemodynamic events.

So sorry to hear about your family's loss.

 

I’m so sorry for your lose of your grandfather. I did the same w/ my grandmother in heart failure. I’m not a doctor but it seems that when a heart grows weak & can’t pump the blood strongly enough, back pressure causes fluid to seep from the vessels into surrounding tissue like the lungs. I think only a cardiologist may be able to explain the dynamics of the particular case.
Take comfort in the fact that your grandfather knew you were there for him in his passing as your love was all around him & he was not afraid. Ah, we all should be so lucky.

 

Michael, you have my condolences.

I've lost all of my family except for my 2 sisters, their children and their grandchildren.

Time will heal your heart............

 

There could be several contributing issues.
If he had left sided heart failure then pressure issues predominate.
The heart as a pump is divided into two sides, the left and the right. Very often it is the left side that fails secondary to coronary vascular damage, and the greater load of work the left side of the heart has done throughout life and has to bear with each beat; that is it pumps blood out into the body through the aorta, the heavily encased main artery coming out of the heart. The right side of the heart has it a little easier since it only has to pump blood into the lower pressure vasculature of the lungs. Lung tissue is very pliable and the vessels contained therein are lower pressure vessels. As the left side fails in its job of pumping blood from the lungs out into the aorta the sepaarte pump of the right heart is pumping blood into the lungs. The buildup of pressure in the vessels in the lungs overcomes the oncotic pressure of the proteins in the blood (keeping the fluid within the "jelly" of the blood) relative to the lower oncotic pressure in the tissues. As a results an ultrafiltrate of blood, like jam being forced through a cheese-cloth, seeps into the small airspaces and interstitium of the lung. This reduces gas exchange in the lung between the air sac (alveolus) and the microvasculature. As tissue damage builds so does an inflammatory reaction adding immune cells and extra fluid load. The process is akin to "drowning" in that fluid in the alveoli prevents gas exchange and oxygen levels in the blood drop, and carbon dioxide builds up. This dimunition in function tends to build slowly, not like someone drowning over seconds/minutes in the ocean.
Take some solace that the slow buildup of carbon dioxide is a neurotoxin and the brain becomes less "aroused" as the neurons lose the ability to conduct electrical impulses and secrete neurotransmitters with the usual exquisite complexity necessary for conscious thought. The effect is a "narcotic" that is sedating, calming and anxiolytic (anti-anxiety inducing).
Your grandfather likely did not suffer, those gurgling sounds bothered you and your family far more that it bothered him....he looked at you from a dream state.
My guess is he is blasting through a winding mountain road in a bright red 275 GTB/4 right now, windows down, V12 in full song, dogwoods in bloom and honeysuckle scents streaming through the vents (or at least I hope he is...or I'm doomed).
Hope this helps.
PM me if you need more help and explanations particular to his situation. This stuff tends to get complicated.

 

My condolences.

 

thank you so much for taking the time to write this for me. your explanation made perfect sense to me. i could not get my pea brain to understand "where" the fluid came from, but it makes sense now. i was also unaware to the c02 effects, and the 11 hours it took for this to happen would make one think it was a gradual slide. i thought the Morphine would have culled the respiration some too, but it seemed to help keep him calm. he would react to touch and our voices to the end, and i do agree he is better off. i need to take heed and make sure my diet is "heart healthy ", as i can only hope to be 88 or so, and still that strong.

 

thanks to all of you for the replies and well wishes. i am ok with this, and am glad to have a better understanding on how this came to be. i hope to further my own life by living a health lifestyle, and being aware of what things run in the family.

thank you.

 

Man ,, that brought a tear to my eye! Sorry about your families loss!

 

Carreaper,

So sorry for your loss. My condolences go out to you and your family.

Best Wishes,
Dom

 

thanks guys, he is better off. and i now have a better understanding about how the body works, and fails. heart disease runs in the family, so i am going to make some changes in diet and routine now, while i am 36!

 

Mike, Sorry for your loss.