Eur Respir J 2006; 28: Suppl. 50, 3800 You must login to share this Presentation/Article on Twitter, Facebook, LinkedIn or by email. Member's Comments No comment yet. You must Login to comment this presentation. [ers-education.org]

Images Snapshot A 29-year-old man presents to the emergency department with severe pleuritic chest pain. He tells the resident that he is worried he might have another collapsed lung. [step2.medbullets.com]

"Paradoxical vocal cord motion disorder: past, present and future". Postgraduate Medical Journal. 83 (977): 164–72. doi:10.1136/pgmj.2006.052522. ISSN 1469-0756. PMC 2599980. PMID 17344570. [en.wikipedia.org]

CASE 29 Clinical Presentation 72-year-old woman with exertional dyspnea Radiologic Findings Unenhanced chest CT (lung window) (Figs. 29.1A, 29.1B, 29.1C, 29.1D) demonstrates bilateral decreased attenuation throughout both lungs with simplification of [radiologykey.com]

This autosomal recessive disorder is characterized by serum API levels below 35% of normal and presents as panacinar emphysema at age 30 to 50 years. [freethesaurus.com]

• Collapse

  All rights reserved. em·phy·se·ma (ĕm′fĭ-sē′mə) A chronic disease in which the small air sacs of the lungs (called alveoli) become enlarged and eventually collapse, causing blockage to the flow of air. [thefreedictionary.com]

  Related health topics Arterial blood gas analysis Chronic obstructive pulmonary disease (COPD) Collapsed lung (pneumothorax) Cor pulmonale Lung function tests Lung transplant Shortness of breath Using oxygen at home – what to ask your doctor [ufhealth.org]

  If they get too big, you may be at risk for a collapsed lung. But that happens rarely. If you still smoke, try to quit. That will help slow the damage from your emphysema. [webmd.com]

  He tells the resident that he is worried he might have another collapsed lung. His temperature is 98.7°F (37.1°C), blood pressure is 118/78 mmHg, pulse is 119/min, respirations are 31/min, and oxygen saturation is 85% on room air. [step2.medbullets.com]

  […] when he opened the chest during an autopsy.[60] He noted that they did not collapse as usual because they were full of air and the airways were filled with mucus.[60] Early descriptions of probable emphysema include: in 1679 by T. [en.wikipedia.org]

• Congestive Heart Failure

  Congestive heart failure[edit] Congestive heart failure frequently presents with shortness of breath with exertion, orthopnea, and paroxysmal nocturnal dyspnea.[2] It affects between 1–2% of the general United States population and occurs in 10% of those [en.wikipedia.org]

  heart failure) Signs of hyperinflated lungs (barrel chest) Hyperlucency of lung tissue (decreased lung markings) Increased anteroposterior diameter Diaphragm pushed down and flattened Horizontal ribs and widened intercostal spaces Long narrow heart shadow [amboss.com]

• Asymptomatic

  Centrilobular emphysema Centrilobular is by far the most common type encountered and is a common finding in asymptomatic elderly patients. [radiopaedia.org]

  Foci of irregular emphysema are asymptomatic and clinically insignificant. The National Heart, Lung, and Blood Institute does not regard irregular emphysema as a form of emphysema but as “airspace enlargement with fibrosis” [5]. [intechopen.com]

  Detection of small airway dysfunction in asymptomatic smokers using aerosol bolus behavior. Am J Resp Crit Care Med 1994;150:995-1001. [Crossref] [PubMed] Anderson PJ, Blanchard JD, Brain JD, et al. [atm.amegroups.com]

• Dyspnea

  […] are useful in knowing the etiology of dyspnea. [en.wikipedia.org]

  CASE 29 Clinical Presentation 72-year-old woman with exertional dyspnea Radiologic Findings Unenhanced chest CT (lung window) (Figs. 29.1A, 29.1B, 29.1C, 29.1D) demonstrates bilateral decreased attenuation throughout both lungs with simplification of [radiologykey.com]

  Chronic obstructive pulmonary disease presents with cough, sputum production, and exertional dyspnea. [intechopen.com]

  Most affected individuals present with a combination of dyspnea and chronic cough with expectoration. In later stages, COPD may manifest with more severe symptoms such as tachypnea, tachycardia, and cyanosis. [amboss.com]

• Cough

  Tell your doctor right away if you notice that you: Get short of breath while climbing stairs and other routine activities Sometimes feel you can’t get enough air into your lungs Can’t shake a cough, or you’re wheezing at times Cough up mucus Feel unusually [webmd.com]

  See “Differential diagnosis of chronic cough.” The differential diagnoses listed here are not exhaustive. [amboss.com]

  In contrast, most asthmatics do not have daily symptoms, but have intermittent episodes of dyspnea, cough, and chest tightness that are usually associated with specific triggers, such as an upper respiratory tract infection or exposure to allergens.[14 [en.wikipedia.org]

  You may also have a chronic cough and have trouble breathing during exercise. The most common cause is cigarette smoking. If you smoke, quitting can help prevent you from getting the disease. [fpnotebook.com]

  […] to terminal bronchiole (i.e., acinus) abnormal dilation of airspaces and destruction of alveoli walls due to proteinases (i.e., elastase) decreased alveolar and capillary surface area, which decreases gas exchange Presentation Symptoms dyspnea mild cough [step2.medbullets.com]

• Sputum

  Patients typically report dyspnea without significant sputum production. [radiopaedia.org]

  Chronic obstructive pulmonary disease presents with cough, sputum production, and exertional dyspnea. [intechopen.com]

  […] patients with AATD: panacinar emphysema, bronchiectasis, bullae Other tests CBC: Increased serum hematocrit Testing for AATD: recommended for all patients with COPD regardless of age or ethnicity (see “Inborn errors of metabolism”) [18] Gram stain and sputum [amboss.com]

  People with chronic obstructive pulmonary disease (COPD), most commonly emphysema or chronic bronchitis, frequently have chronic shortness of breath and a chronic productive cough.[2] An acute exacerbation presents with increased shortness of breath and sputum [en.wikipedia.org]

• Barrel Chest

  A chest radiograph is obtained. [step2.medbullets.com]

  Here are some symptoms to look out for: Shortness of breath Cough Wheezing Decrease in exercise tolerance Pursed lip breathing (exhaling through tightly pressed lips and inhaling through the nose with mouth closed) Barrel chest (distance from chest to [ufhealth.org]

  Signs of emphysema include: tachypnea absence of cyanosis pursed-lip breathing, tripod position chest hyperinflation "barrel chest" reduced breath sounds hyper-resonant to percussion cor pulmonale (late) Emphysema is one of a heterogeneous group of pathological [radiopaedia.org]

  […] be used to determine the etiology for an acute COPD exacerbation (e.g., pneumonia, congestive heart failure) Signs of hyperinflated lungs (barrel chest) Hyperlucency of lung tissue (decreased lung markings) Increased anteroposterior diameter Diaphragm [amboss.com]

  Patients with advanced emphysema due to hyperinflation of lungs have barrel chest with poor diaphragmatic excursion as assessed by percussion and dramatic decrease in breath sounds and are sitting in the characteristic tripod position with stretched fixed [intechopen.com]

• Chronic Cough

  You may also have a chronic cough and have trouble breathing during exercise. The most common cause is cigarette smoking. If you smoke, quitting can help prevent you from getting the disease. [fpnotebook.com]

  See “Differential diagnosis of chronic cough.” The differential diagnoses listed here are not exhaustive. [amboss.com]

  Emphysema is a chronic, usually slowly progressive illness, which most commonly causes shortness of breath. Other symptoms may include chronic cough, phlegm production, and wheezing. Frequent respiratory infections may also occur. [rarediseases.org]

  Emphysema Advanced centrilobular emphysema showing total lobule involvement on the left side Specialty Pulmonology Symptoms Shortness of breath, chronic cough[1] Usual onset Over 35 years old[1] Duration Long term[1] Causes Tobacco smoking,[2] air pollution [en.wikipedia.org]

• Heart Failure

  The degree of coexisting illness: i.e. heart failure/systemic hypertension, heart failure/pulmonary hypertension, heart failure/diabetes, heart failure/kidney failure, etc. [en.wikipedia.org]

  Cor pulmonale (right heart failure) Secondary spontaneous pneumothorax due to rupture of bullae (especially in bullous emphysema) We list the most important complications. The selection is not exhaustive. [amboss.com]

  Prognosis is worse in patients who continue to smoke, are alpha-1-antitrypsin deficient, have low FEV1 at time of diagnosis, or have other comorbidities (e.g. heart failure, respiratory failure, frequent exacerbations). cystic lung disease: all have visible [radiopaedia.org]

• Hunger

  Distinct sensations include effort/work to breathe, chest tightness or pain, and "air hunger" (the feeling of not enough oxygen).[1] The tripod position is often assumed to be a sign. [en.wikipedia.org]

  Dyspnea during physical activity may start insidiously, and patients complain of difficult breathing, gasping and air hunger, heaviness in chest in the beginning only during rather heavy physical work and later during light daily physical activity. [intechopen.com]

• Hyperactivity

  This usually occurs a lot earlier, as does HIV associated emphysema than other types.[32] Ritalin lung[edit] The intravenous use of methylphenidate, commonly marketed as Ritalin and widely used as a stimulant drug in the treatment of attention deficit hyperactivity [en.wikipedia.org]

  Other components are chronic bronchitis, small airway disease, small airway hyperactivity, and inflammation. Chronic obstructive pulmonary disease presents with cough, sputum production, and exertional dyspnea. [intechopen.com]

• Atelectasis

  "Pre-emergence Oxygenation and Postoperative Atelectasis". Anesthesiology. 131 (4): 771–773. doi:10.1097/ALN.0000000000002875. PMID 31283741. S2CID 195842599. ^ Dale WA, Rahn H (September 1952). "Rate of gas absorption during atelectasis". [en.wikipedia.org]

In 85% of cases it is due to asthma, pneumonia, cardiac ischemia, interstitial lung disease, congestive heart failure, chronic obstructive pulmonary disease, or psychogenic causes,[2][3] such as panic disorder and anxiety.[4] The best treatment to relieve [en.wikipedia.org]

Supportive treatment (e.g., postural drainage) Vitamin D3 and calcium in cases of deficiency [20] Medical treatment according to GOLD [1] Medical treatment in COPD reduces the severity of symptoms, improves overall health status, and lowers the frequency [amboss.com]

All hamsters examined 6 and 12 mo after elastase treatment showed the lesion. [jci.org]

However, the prognosis decreases if the individual decides to continue to smoke. [ufhealth.org]

Dynamic breathing MRI may have a future role in assessing pulmonary emphysema.5 Treatment and prognosis Unfortunately, once lung tissue is lost, no regrowth occurs. [radiopaedia.org]

PMID: 8005246 Prognosis Hunt DP, Weil R, Nicholson AG, Burke MM, Du Bois RM, Wells AU Sarcoidosis Vasc Diffuse Lung Dis 2006 Mar;23(1):70-2. [ncbi.nlm.nih.gov]

People with a VO2 max <10 cc/kg/min have a clearly poorer prognosis. [en.wikipedia.org]

Clinical course and prognosis of patients with chronic obstructive pulmonary disease. [amboss.com]

Etiology alpha-1 antitrypsin deficiency: classical cause and may show a lower zone predominance Ritalin lung Swyer-James syndrome: affects one lung obliterative bronchiolitis 3 can also manifest as a normal senescent finding in non-smokers 3 Radiographic [radiopaedia.org]

Etiology The familial form of panacinar emphysema is seen in association with α-1-antiprotease deficiency. [radiologykey.com]

Anat 2015;28:227) Increase in size and number of small fenestrae in alveolar walls (pores of Kohn), which leads to loss of elastic recoil Breakdown and merging of fibrovascular trabeculae (framework) Remodeling of acini results in airspace enlargement Etiology [pathologyoutlines.com]

[…] and destroys elastic tissues can accumulate in hepatocytes and cause cirrhosis Epidemiology Demographics males > females 4th most common cause of death globally Risk factors tobacco use (most common) air pollution occupational exposure AAT deficiency ETIOLOGY [step2.medbullets.com]

Etiology Clin Chest Med 2020 Sep;41(3):339-345. doi: 10.1016/j.ccm.2020.05.003. PMID: 32800189 Vizzardi E, Corda L, Sciatti E, Roca E, Redolfi S, Arici M, Pini L, Bonadei I, Metra M, Tantucci C Eur J Clin Invest 2015 Sep;45(9):949-54. [ncbi.nlm.nih.gov]

[…] panlobular/panacinar rare and caused by alpha-1-antitrypsin deficiency misfolded alpha-1-antitrypsin (AAT), which normally inhibits elastase without AAT, elastase is over active and destroys elastic tissues can accumulate in hepatocytes and cause cirrhosis Epidemiology [step2.medbullets.com]

Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

Epidemiology[edit | edit source] Emphysema, as a part of COPD, is an illness that affects a large number of people worldwide. In 2016, the Global Burden of Disease Study reported a prevalence of 251 million cases of COPD globally. [physio-pedia.com]

Alpha-1 antitrypsin deficiency. 1: Epidemiology of alpha-1 antitrypsin deficiency. Thorax 2004;59(2):164-169. Fischer S, et al. Current status of lung transplantation: patients, indications, techniques and outcome. Med Klin. 2002;97:137-43. [rarediseases.org]

[…] before prescribing medication.[19] The use of systematic corticosteriods in palliative care for people with cancer is common, however the effectiveness and potential adverse effects of this approach in adults with cancer has not been well studied.[19] Epidemiology [en.wikipedia.org]

[…] fibrosis : Cystic fibrosis pathophysiology, Cystic fibrosis diagnosis. [play.google.com]

Centriacinar is really related to inflammation, which is the first pathophysiology of emphysema. Now inflammation recruits neutrophils, these white blood cells that flight inflammation everywhere in the body. [khanacademy.org]

The pathophysiology of emphysema: Considerations for critical care nursing practice. Intensive and Critical Care Nursing 2006; 22: 329-337. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 Hough A. Physiotherapy in respiratory and cardiac care. [physio-pedia.com]

[…] pulmonary disease (COPD) is defined as persistent airflow limitation due to mixture of small airway disease and parenchymal destruction early classifications distinguished emphysema and chronic bronchitis no longer distinguished but helpful to separate for pathophysiologic [step2.medbullets.com]

[…] unspecified Sites Centriacinar emphysema Upper lobe predominant Respiratory bronchioles and surrounding lung parenchyma Panacinar emphysema Lower lobe predominant Entire acinus Paraseptal emphysema Upper lung Distal part of acinus in subpleural area Pathophysiology [pathologyoutlines.com]

[Guideline] Centers for Disease Control and Prevention. Updated recommendations for prevention of invasive pneumococcal disease among adults using the 23-valent pneumococcal polysaccharide vaccine (PPSV23). [emedicine.medscape.com]

If you smoke, quitting can help prevent you from getting the disease. If you already have emphysema, not smoking might keep it from getting worse. Treatment is based on whether your symptoms are mild, moderate or severe. [fpnotebook.com]

Screening for Chronic Obstructive Pulmonary Disease: Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2016 Apr 5. 315 (13):1378-93. [Medline]. [Guideline] US Preventive Services Task Force. [medscape.com]

Pulmonary rehabilitation for patients with severe symptoms and multiple exacerbations reduces dyspnea and hospitalizations. [1] Prevention[edit | edit source] As COPD is the umbrella term used for diseases like Emphysema, the prevention strategies are [physio-pedia.com]

Laryngitis diagnosis, treatment, and prevention, Laryngomalacia, Vocal cord growths 14- Bronchiolitis Bronchiolitis pathophysiology, Bronchiolitis diagnosis, Bronchiolitis treatment Delineate the structures of respiratory system and their functions. [play.google.com]