Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable lung disease that is characterized by airflow obstruction and alveolar problems. The airflow obstruction is generally progressive and irreversible. Clinical features of COPD closely resembles chronic bronchitis and emphysema chronic bronchitis is manifested by daily productive expectations for 3 months or more in 2 consecutive years. Emphysema is distal air spaces and destruction of alveoli. In addition, extrapulmonary features like anorexia, weight loss and muscle weakness are also found in this condition.
Multiple risk factors predispose COPD (Chronic Obstructive Pulmonary Disease). Tobacco smoking is the most common and most significant risk factor for developing this lung disease. Other risk factors are –
Signs and symptoms of COPD (Chronic Obstructive Pulmonary Disease) are commonly present over 40 years of age. Common presenting symptoms include shortness of breath, excess cough associated with sputum production. The disease usually starts with dyspnoea on heavy work. After that disease progresses and dyspnoea occurs with mild work or at rest. The MMRC ( Modified Medical Research Council ) grading system is used to diagnose the severity of COPD. In majority cases, acute exacerbation of the disease occurs periodically. Acute exacerbation is manifested by increased dyspnoea and increased cough and sputum. However, the acute exacerbation is associated with a viral or bacterial infection. Later stages of COPD may be characterized by pulmonary hypertension, cor pulmonale or chronic respiratory failure.
Spirometry provides useful information about the pulmonary function and helps to diagnose various obstructive lung diseases. At early stages of COPD may show reduced mid expiratory flow rate. COPD differs from asthma by bronchodilator reversibility as it is little or no severability FEV1 / FVC less than 0.7 and FEV1 is less than 80% of the predicted value indicates airflow obstruction. The severity of COPD is based on spirometric classification of post-bronchodilator FEV1 and FVC. The helium dilution technique is used for measuring lung volume and hyperinflation. Radiographs like x-ray and CT scans are also helpful for diagnosis. Hyperinflation of lung and flattening of the diaphragm are common radiological features. HRCT ( High-resolution computed tomography ) is more sensitive and specific than a plain x-ray. In advance stages of COPD, doppler echocardiography is used to measure pulmonary artery pressure for diagnosing pulmonary artery hypertension.
Generally, complications occur during the advanced stage of COPD (Chronic Obstructive Pulmonary Disease). Common complications include cor pulmonale, pulmonary hypertension and chronic respiratory failure. However, spontaneous pneumothorax or hemoptysis may occur rarely.
The main aim of COPD treatment includes acute reducing dyspnoea and preventing acute reducing dyspnoea and preventing exacerbations. Stable COPD patients may take home-based treatment but acute exacerbations need hospitalization.