Date Assigned to Patient: 9/14/2011
Name of Major Medical Diagnosis: Chronic Obstructive Pulmonary Disease (COPD)
Definition: COPD is a progressive disease that makes it hard to breathe. "Progressive" means the
disease get worse over time. It can cause coughing that produces large amount of mucus,
wheezing, shortness of breath, chest tightness, and other symptoms.
Etiology: Most cases of COPD occur as a result of long-term exposure to lung irritants that damage
the lungs and the airways.
In the United States, the most common irritant that causes COPD is cigarette smoke. Pipe, cigar, and other types of tobacco smoke also can cause COPD, especially if the smoke is inhaled. Breathing in secondhand smoke, air pollution, and chemical fumes or dust from the environment or workplace also can contribute to COPD. (Secondhand smoke is smoke in the air from other people smoking.) In rare cases, a genetic condition called alpha-1 antitrypsin deficiency may play a role in causing COPD. People who have this condition have low levels of alpha-1 antitrypsin (AAT)—a protein made in the liver. Having a low level of the AAT protein can lead to lung damage and COPD if you're exposed to smoke or other lung irritants. If you have this condition and smoke, COPD can worsen very quickly. Signs and symptoms: The signs and symptoms of COPD include: * An ongoing cough or a cough that produces large amounts of mucus (often called "smoker's cough") * Shortness of breath, especially with physical activity
* Wheezing (a whistling or squeaky sound when you breathe) * Chest tightness
These symptoms often occur years before the flow of air into and out of the lungs declines. However, not everyone who has these symptoms has COPD. Likewise, not everyone who has COPD has these symptoms. Some of the symptoms of COPD are similar to the symptoms of other diseases and conditions. You can find out whether you have COPD. If you have COPD, you may have colds or the flu (influenza) frequently. If your COPD is severe, you may have swelling in your ankles, feet, or legs; a bluish color on your lips due to a low blood oxygen level; and shortness of breath. COPD symptoms usually slowly worsen over time. At first, if symptoms are mild, you may not notice them, or you may adjust your lifestyle to make breathing easier. For example, you may take the elevator instead of the stairs. Over time, symptoms may become severe enough to see a doctor. For example, you may get short of breath during physical exertion. How severe your symptoms are depends on how much lung damage you have. If you keep smoking, the damage will occur faster than if you stop smoking. In severe COPD, you may have other symptoms, such as weight loss and lower muscle endurance. Some severe symptoms may require treatment in a hospital. You—with the help of family members or friends, if you're unable—should seek emergency care if: * You're having a hard time catching your breath or talking. * Your lips or fingernails turn blue or gray. (This is a sign of a low oxygen level in your blood.) * You're not mentally alert.
* Your heartbeat is very fast.
* The recommended treatment for symptoms that are getting worse isn't working.
Diagnostic Procedures: Your doctor will diagnose COPD based on your signs and symptoms, your
family and medical histories, and test results.
He or she may ask whether you smoke or have had contact with lung irritants, such as secondhand smoke, air pollution, chemical fumes, or dust. If you have an ongoing cough, your doctor may ask how long you've had it, how much you cough, and how much mucus comes up when you cough. He or she also may ask whether you have a family history of COPD. Your doctor will examine you and use a stethoscope to listen for wheezing or other abnormal chest sounds. You also may need one or more tests to diagnose COPD.
Lung Function Test: Lung function tests measure how much air you can breathe...