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Pulmonologists diagnose and treat lung diseases such as asthma,
emphysema, or pneumonia. They perform tests to check how well a person
is breathing, or they may use procedures, such as bronchoscopy, to
diagnose a breathing problem. A term used to describe chronic airway obstruction that results from emphysema, chronic bronchitis, asthma, or any combination of these disorders. Most often, the combination involves bronchitis and emphysema. It affects about 17 million people in the US and the incidence is rising. More men than women are affected (until recently, men were more likely to be the heavy smokers). Interstitial Lung Disease Interstitial lung disease (ILD) is a common term that includes more than 130 chronic lung disorders. When a person has ILD, the lung is affected in three ways. First, the lung tissue is damaged in some known or unknown way. Second, the walls of the air sacs in the lung become inflamed. Finally, scarring (or fibrosis) begins in the interstitium (or tissue between the air sacs), and the lung becomes stiff. Lung Cancer [Description needed] Pneumonia Pneumonia is an inflammation of the lung caused by infection with bacteria, viruses, and other organisms. Pneumonia is usually triggered when a patient’s defense system is weakened, most often by a simple viral upper respiratory tract infection or a case of influenza. Such infections or other triggers do not cause pneumonia directly but they alter the mucous blanket, thus encouraging bacterial growth. Other factors can also make specific people susceptible to bacterial growth and pneumonia. Pulmonary Hypertension High blood pressure in the arteries that supply the lungs is called pulmonary hypertension (PHT). The blood pressure measured by cuff on your arm isn’t directly related to the pressure in your lungs. The blood vessels that supply the lungs constrict and their walls thicken, so they can’t carry as much blood. As in a kinked garden hose, pressure builds up and backs up. The heart works harder, trying to force the blood through. If the pressure is high enough, eventually the heart can’t keep up, and less blood can circulate through the lungs to pick up oxygen. Patients then become tired, dizzy and short of breath. Dyspnea Many people suffer from the difficult, labored, uncomfortable breathing known as Dyspnea. Approximately 14 million Americans suffer from chronic obstructive pulmonary disease (COPD). Another 10 million citizens (approximately five percent of the population) have asthma. When interstitial lung disease, neuromuscular disorders, lung cancer, and cardiac disease are added to the mix, it is clear that breathing discomfort or significant breathlessness is a serious problem for many persons in the U.S. Bronchiectasis This is a chronic lung disease that damages the muscle and elastic tissue of the airways within the lungs. Permanent dilation of the airways can be a result of the damaged bronchial wall. Dilation can be a uniform enlargement or irregular and result in the formation of pouches. The pouches in the airways are susceptible to infection because bacteria thrive in these warm, dark and moist areas. When small infections accumulate, someone with Bronchiectasis may become very ill. Occupationally Related Lung Disease [Description needed] Pleural Effusions Fluid that accumulates in the pleural space because of trauma or disease is called pleural effusion. This condition may result from heart failure, cancer, pulmonary embolism, or inflammation. If blood is in the accumulating fluid, the condition is called “hemothorax”; if pus is present, it is called “empyema”; if air enters the space, it is called “pneumothorax”; and if there is chyle (milky fluid consisting of lymph and fat), it is called “chylothorax.” There are two types of pleural effusion, transudative and exudative. Sarcoidosis Sarcoidosis is a disease that affects many organ systems, but the most commonly affected are the lungs and the lymph nodes of the chest. In most cases, Sarcoidosis resolves itself within two years. However, in about 1/10 of all cases Sarcoidosis progresses to the point of fibrosis or scarring. When this occurs in the lungs, it can produce a chronic cough and shortness of breath. Lymph nodes may be enlarged, which is usually of no consequence. Skin lesions may develop, often in scars. If the heart muscle is affected, heart failure may occur. Again, this severe form of Sarcoidosis only occurs in about 10 percent of all people suffering from sarcoidosis.
Smoking Cessation Thoracentesis is a procedure to remove fluid from the space between the lining of the outside of the lungs (pleura) and the wall of the chest. Normally, very little fluid is present in this space. An accumulation of excess fluid between the layers of the pleura is called a pleural effusion. Bronchial Challenge Testing / Interpretation Provocholine or methacholine is used to perform this test when it is necessary to determine if an individual has hyper-responsive airways. The testing is performed using in an isolated chamber. The patient inhales gradually increasing concentrations of the Provocholine while pulmonary function is monitored. Bronchial challenge testing is used to determine hyper-responsive airways, the diagnoses of cough variant asthma or atypical asthma Bronchoscopy with Biopsy Bronchoscopy is an examination that allows a doctor to see inside the airway. During bronchoscopy, an instrument called a bronchoscope is used to look at the throat, larynx, trachea, and lower bronchial airways of the lungs. Bronchoscopy may be done to identify problems that may be causing inflammation and bleeding; diagnose certain lung diseases; and to diagnose and determine the extent of lung cancer. Sleep Study Interpretation A polysomnograph is a test of sleep cycles and stages through the use of continuous recordings of brain waves (EEG), electrical activity of muscles, eye movement (electrooculogram), breathing rate, blood pressure, blood oxygen saturation, and heart rhythm and direct observation of the person during sleep. There are two states of sleep: non-rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep. REM sleep is associated with dreaming and paralysis of body muscles (except for the eye and diaphragm muscles). NREM sleep has four stages distinguishable by EEG waves. REM sleep alternates with NREM sleep approximately every 90 minutes. A person with normal sleep usually has four to five cycles of REM and NREM sleep during a night. |
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