Cardiomegaly and Mitral Sclerosis

[luislu]

I was recently taken to the hospital because my lungs were filling with water and phlegm. At that time, they said it was Pneumonia. But I had to go back a second time, and this time, they said my lungs were filling with water and phlegm, and my heart was enlarged. Now, they said the water in my lungs has nothing to do with pneumonia but is caused by my heart being enlarged. According to my latest X-Ray results, I have Cardiomegaly, left ventricular form. According to my 2D Echo, I have Mitral Sclerosis with moderate mitral regurgitation. Are those caused by pneumonia? What's the best way to go about this? My doctor can't seem to make up his mind on what's causing them.

[kenkeith]

For a perspective, pulmonary edema (water in the lungs) and pneumonia are separate issues.  Pulmonary edema is usually related to LV dysfunction.  It appears the underlying problem is the mitral valve sclerosis (narrowing of opening) and mitral valve regurgitation.  The valve problems can stress the heart and cause it to enlarge, and/or an ischemic enlarged LV can aggravate the valve problems especially MVR.

Pulmonary edema occurs when the heart (because of enlargement) doesn't pump out into circulation the supply of blood received from the lungs causing blood to back up into lungs and fluids leak into pulmonary tissues.  The condition will cause a violent dry cough, choking, feeling of not getting enough oxygen...some relief when not lying down, but sitting up.  I had mild pulmonary edema, severe edema must be the same as drowning!

Pneumonia is the inflammation of the lung tissues and coughing phlegm would be an expectation, but edema is a dry cough.  Treatment would be to reduce LV size with medication, and treat the inflammation as separate issue.  A reduction in LV size can or may help reduce MVR.