Chronic Obstructive Pulmonary Disease

Pulmonology

Overview

Definition

A common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities.

Epidemiology

Third leading cause of death worldwide. Highly correlated with smoking.

Etiology & Risk Factors

  • Tobacco smoking
  • Biomass fuel exposure
  • Alpha-1 antitrypsin deficiency

Clinical Symptoms

  • Chronic progressive dyspnea
  • Chronic cough
  • Sputum production
  • Wheezing

Clinical Approach

Diagnosis

  • Spirometry showing post-bronchodilator FEV1/FVC < 0.70
  • Chest X-ray (hyperinflation, flattened diaphragm)
  • ABG (in severe cases for hypercapnia)

Management

  • Smoking cessation
  • Bronchodilators (LABA/LAMA)
  • Inhaled corticosteroids (ICS) for exacerbations/frequent exacerbators
  • Oxygen therapy (if resting PaO2 ≤ 55 mmHg)
  • Pulmonary rehabilitation

Complications

  • Acute exacerbations
  • Cor pulmonale (Right heart failure)
  • Pneumothorax
  • Respiratory failure