Chronic Obstructive Pulmonary Disease (COPD)

By Andrew Buscaglia

Emphysema

Diagnosis Pulmonary function test

Chest X-ray

Arterial blood gas

CausesSmoking is the Leading cause of Emphysema

Cigarette smoke is by far the most common cause of emphysema.

(1) There are more than 4,000 chemicals in tobacco smoke, including secondhand smoke.

These chemical irritants slowly destroy the small peripheral airways, the elastic air sacs and their supporting elastic fibers.

Causes cont.Protein deficiency.

(1) Approximately 1 to 2 percent of people with emphysema have an inherited deficiency of a protein called AAt, which protects the elastic structures in the lungs.

Without this protein, enzymes can cause progressive lung damage, eventually resulting in emphysema.

If you're a smoker with a lack of AAt, emphysema can begin in your 30s and 40s.

The progression and severity of the disease are greatly accelerated by smoking.

Is It TransmittedThis disease is not Transmitted because it is caused by smoking.

Who does it target

Adults that smoke for a long time would get emphysema

Males and females that get the disease have been smoking for a long time or are exposed to 2nd hand smoke for a long time.

SymptomsEmphysema symptoms are mild to begin with but steadily get worse as the disease progresses. The main emphysema symptoms are:

* Shortness of breath

* Wheezing

* Chest tightness

* Reduced capacity for physical activity

* Chronic coughing, which could also indicate chronic bronchitis

* Loss of appetite and weight

* Fatigue

When to see a doctor

* You tire quickly, or you can't easily do the things you used to do

* productive chronic cough

* You can't breathe well enough to tolerate even moderate exercise

* Your breathing difficulty worsens when you have a cold

* Your lips or fingernails are blue or gray, indicating low oxygen in your blood

* You frequently cough up yellow or greenish sputum

* You note that bending over to tie your shoes makes you short of breath

* You are losing weight

Risk FactorsSmoking Emphysema is most likely to develop in cigarette smokers, but cigar and pipe smokers also are susceptible, and the risk for all types of smokers increases with the number of years and amount of tobacco smoked.

Age Although the lung damage that occurs in emphysema develops gradually, most people with tobacco-related emphysema begin to experience symptoms of the disease between the ages of 40 and 60.

Exposure to secondhand smoke Secondhand smoke, also known as passive or environmental tobacco smoke, is smoke that you inadvertently inhale from someone else's cigarette, pipe or cigar. Being around secondhand smoke increases your risk of emphysema.

Risk factors cont.Occupational exposure to fumes or dust. If you breathe fumes from certain chemicals or dust from grain, cotton, wood or mining products, you're more likely to develop emphysema. This risk is even greater if you smoke.

Exposure to indoor and outdoor pollution. Breathing indoor pollutants, such as fumes from heating fuel, as well as outdoor pollutants — car exhaust, for instance — increases your risk of emphysema.

ComplicationsEmphysema can increase the severity of other chronic conditions, such as diabetes and heart failure.

If you have emphysema, air pollution or a respiratory infection can lead to an acute COPD exacerbation, with extreme shortness of breath and dangerously low oxygen levels.

You may need admission to an intensive care unit and temporary support from an artificial breathing machine (ventilator) until the infection clears.

Treatments 1The most important step in any treatment plan for smokers with emphysema is to stop smoking; it's the only way to stop the damage to your lungs from becoming worse. But quitting is never easy, and people often need the help of a comprehensive smoking cessation plan, which may include:

A target date to quit

Relapse prevention

Advice for healthy lifestyle changes

Social support systems

(2) Medications, such as nicotine gum or patches and the prescription medications bupropion hydrochloride (Zyban) and varenicline (Chantix)

Treatments 2 Medications that dilate the bronchioles dilate airways and improve breathing

Inhaled or oral steroids reduce lung inflammation.

Supplemental oxygen if you have severe emphysema with low blood oxygen levels, using oxygen regularly at home improves blood oxygen saturations

Pulmonary rehabilitation program a key part of treatment that involves a pulmonary rehabilitation program, which combines education and exercise training.

Treatments 3Antibiotics if you develop a bacterial infection like bronchitis or pneumonia, antibiotics are appropriate.

Inoculations against influenza and pneumonia.

Surgical procedure called lung volume reduction surgery

In another surgery, called a bullectomy, doctors remove one or more of the large air spaces that form when the small air sacs are destroyed.

Transplant. Lung transplantation is an option if you have severe emphysema and other options have failed.

Can it be prevented

Emphysema can be prevented by not smoking or spending to much time around 2nd hand smoke.

The End