Diagnostics

CBC (increased in pneumonia or sepsis), serum electrolytes

↑ Cardiac biomarkers, such as troponin in patients with acute myocardial injury [2]

↑ BNP in patients with congestive heart failure

Hypoalbuminemia (≤ 3.4 g/dL) in patients with acute decompensated heart failure

Renal function tests (e.g., ↑ creatinine in renal failure)

↑ Lipase and/or amylase in patients with acute pancreatitis

X-ray chest: posteroanterior and lateral views [4]

• Findings in cardiogenic pulmonary edema

  • Central edema

  • Kerley B lines: visible horizontal interlobular septa caused by pulmonary edema

  • Pleural effusions

  • Enlarged heart size

  • Peribronchial cuffing

• Findings in noncardiogenic pulmonary edema

  • Patchy and peripheral edema

  • Possibly ground-glass opacities and consolidations with air bronchograms

ECG: to diagnose cardiac ischemia (e.g., myocardial infarction)

Echocardiography: to diagnose or evaluate left ventricular systolic dysfunction and valvular dysfunction

Pulmonary artery catheterization

• Gold standard to determine the cause of pulmonary edema

• Helps monitor systemic vascular resistance, cardiac output, filling pressures within the cardiac chambers, and pulmonary capillary wedge pressure (PCWP)