Anthony Foley death: What is pulmonary oedema?

A doctor writes on the cause of Foley’s premature death aged 42

Irish Times rugby correspondent Gerry Thornley speaks about former Munster and Ireland back row Anthony Foley, who passed away suddenly aged 42. Video: Second Captains/Inpho

 

As tributes continue to paid to Munster rugby legend Anthony Foley following his premature death at the age of 42, a French coroner has confirmed he died from pulmonary oedema brought on by heart disease.

Pulmonary oedema is the medical term for the acute flooding of the lungs with fluid. The most common cause is severe heart failure.

Our lungs contain small elastic air sacs called alveoli. With each breath, they take in oxygen and release carbon dioxide. However, when an overworked left ventricle — the main pumping chamber in the heart — isn’t able to pump out enough of the blood it receives from the lung, the resulting back pressure causes fluid to be pushed through the walls of small blood vessels in the lung and into the air sacs.

This type of pulmonary oedema is called cardiogenic and is by far the commonest cause of lungs filling with fluid. Other causes, but with different mechanisms, include acute respiratory distress syndrome and high altitude pulmonary oedema.

About 50 per cent of cases of cardiogenic pulmonary oedema are the result of an acute narrowing of the coronary arteries that supply the heart. This, in turn, interferes with its pumping action, leading to heart failure and the build up of fluid.

Other types of heart disease can also lead to acute heart failure: the sudden onset of a rhythm disorder in the heart; a diseased heart valve; damaged heart muscle due to causes other than blood flow problems (cardiomyopathy); and untreated or uncontrolled high blood pressure.

A person with pulmonary oedema will experience severe shortness of breath, a wheeze and sometimes will bring up blood — tinged frothy sputum. A medical emergency, the condition is treated with oxygen, intravenous drugs including diuretics, morphine and sometimes a drug that boosts the pumping action of the heart.

However, as was the case with the late Anthony Foley, pulmonary oedema can unfortunately be fatal.