Presentation
Here, we present a case of a 3-month-old former full term male infant with no history of RDS or mechanical ventilation who presented with focal cystic lung disease associated with spontaneous tension pneumothorax. [ncbi.nlm.nih.gov]
Abstract Obstructive pulmonary emphysema is a common disorder which presents many problems to the practicing physician and the investigator. [annals.org]
Entire Body System
- Collapse
In the presence of pulmonary emphysema, loss of retractility prevented total collapse of the underlying lung. [ncbi.nlm.nih.gov]
This causes the airways to collapse as you exhale, preventing the air in your lungs from escaping. More than 4.7 million people in the United States have emphysema, with more than 90 percent over the age of 45. [nm.org]
[…] pulmonary parenchyma is attracted in its uneven collapse, thus widening the intrapulmonary air space. [fondazionecarrel.org]
When the alveoli becomes damaged so do the tiny fibers that hold open the airways leading to the alveoli, causing them to collapse and trap air every time the patient expels air. The number one cause of emphysema is long-term cigarette use. [1stclassmed.com]
- Fatigue
[…] deep in the lungs) Wheezing Shortness of breath with activity As the disease progresses, patients may experience: Increased shortness of breath and rapid breathing Choking sensation when lying flat (may need to prop up with pillows or sleep in a chair) Fatigue [umms.org]
The patient with chronic bronchitis has in addition to symptoms of breathlessness and fatigue a chronic cough with phlegm. [tabletsmanual.com]
When patients with stable COPD complain of dyspnea or fatigue during exercise, however, these symptoms are often attributed to COPD, and noninvasive cardiac imaging is routinely performed, leaving potential LV dysfunction undetected. [appliedradiology.com]
Until then, the only symptoms may be a gradual development of shortness of breath and tiredness (fatigue), which can be mistaken for other illnesses. [my.clevelandclinic.org]
- Weight Loss
Nutritional Support: since emphysema may cause malnutrition and weight loss. Medications Antibiotics: For bacterial infections. Bronchodilators: Either oral or inhaled. These are the mainstay of treatment. [integrisok.com]
Weight management Being overweight can make it harder to breathe. A weight loss plan may be needed. Some find it hard to eat well with COPD. It can lead to unhealthy weight loss. Nutrition support may help. [wnyurology.com]
loss Diagnosing Emphysema The doctor will ask about your symptoms and medical history, and perform a physical exam. [umms.org]
Weight loss, which is common in patients with advanced emphysema, can be caused by inadequate food intake in individuals too short of breath to eat. [columbiasurgery.org]
- Hypoxemia
This V/Q mismatch results in rapid circulation in a poorly ventilated lung, leading to hypoxemia and polycythemia. Eventually, hypercapnia and respiratory acidosis develop, leading to pulmonary artery vasoconstriction and cor pulmonale. [emedicine.com]
In more advanced cases, when the patient already has a persistent hypoxemia (low blood oxygen), the use of supplemental oxygen is indicated. [tabletsmanual.com]
On admission, he had intense tachypnea (32 breaths per minute) due to severe hypoxemia (38.5mmHg) and a heart rate of 90 beats per minute. [archbronconeumol.org]
For patients with advanced COPD, gas exchange abnormalities usually result in hypoxemia and hypercapnia. [jtd.amegroups.com]
Interventions include: smoking cessation oxygen therapy (in chronic hypoxemia) symptom and exacerbation control short and long-acting beta-2 agonists inhaled anticholinergics inhaled glucocorticoids antibiotics pulmonary rehabilitation In patients with [radiopaedia.org]
- Asymptomatic
At 11 years after transplant, although the patient was still asymptomatic and had a stable lung function, recurrence of emphysema on the grafted side was diagnosed on computerized tomography of the thorax. [ncbi.nlm.nih.gov]
Most cases are asymptomatic, but if sufficient air accumulates, it can cause cardiac tamponade. [msdmanuals.com]
Between February 2009 and April 2011, 8649 asymptomatic healthy volunteers in the age of 50-75, with at least 20 pack-years smoking history underwent chest Low-Dose Computed Tomography (LDCT) screening in the Pilot Pomeranian Lung Cancer Screening Program [posterng.netkey.at]
Respiratoric
- Cough
Smoking cigarettes Long-term second-hand or passive smoke exposure Family members with emphysema Exposure to pollutants at work History of frequent childhood lung infections Age: 50 or older Symptoms of Emphysema Early symptoms include: Coughing in the [umms.org]
The most frequent cause is the violent strain attending the paroxysm of coughing in bronchitis, whooping-cough, or asthma. [henriettes-herb.com]
We present the case of a 6-year-old white boy with chronic cough and dyspnea on exertion. [ncbi.nlm.nih.gov]
Sputum culture This test is done on the material that is coughed up from the lungs and into the mouth. A sputum culture is often used to see if an infection is present. [hopkinsmedicine.org]
- Dyspnea
Feasibility, safety, and efficacy were analyzed by means of pulmonary function testing, 6-min walk test, dyspnea score, BODE (body mass index, air-flow obstruction, dyspnea, and exercise capacity) index, and St George's Respiratory Questionnaire. [ncbi.nlm.nih.gov]
At first the lips and fingers become blue, but as compensation gives way, or when the dyspnea is severe, the face becomes puffy and very blue. Cough . [henriettes-herb.com]
- Respiratory Distress
This patient was a normal full-term baby with no respiratory distress symptom and no experience of assisted mechanical ventilation. [ncbi.nlm.nih.gov]
- Barrel Chest
[…] size (barrel chest) Increased risk of serious lung infections Enlargement of the right chamber of the heart and possibly heart failure Coughing up thick and/or bloody mucus Swelling in the legs Weight loss Diagnosing Emphysema The doctor will ask about [umms.org]
In addition to shortness of breath, patients with emphysema may suffer from wheezing, coughing, a tight feeling in the chest, fatigue, difficulty sleeping and a barrel-chested appearance. [uhhospitals.org]
Other common signs and symptoms of emphysema include: Tightness in the Chest Fatigue Chronic Cough Expanded Chest or "Barrel Chest" Clubbing of the Fingers May be Noticed as Emphysema Progresses Collapsed Lung What Leads to Emphysema Long-term regular [1stclassmed.com]
- Tachypnea
We report the case of 2-week-old female infant with cystic lung disease who presented with mild tachypnea and had no history of mechanical ventilation. [ncbi.nlm.nih.gov]
On admission, he had intense tachypnea (32 breaths per minute) due to severe hypoxemia (38.5mmHg) and a heart rate of 90 beats per minute. [archbronconeumol.org]
He was admitted to the neonatal intensive care unit with tachypnea and recessions, for which he was started on 5 cm nasal continuous positive airway pressure (CPAP). [omjournal.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]
Gastrointestinal
- Vomiting
[…] from the lungs to the left atrium of the heart bulima nervosa a disorder of eating in which the person alternates between strong craving for food and aversion to food; characterized by excessive eating followed by periods of fasting or self-induced vomiting [vocabulary.com]
Nausea, vomiting, abdominal pain, and nonbloody diarrhea developed on day 7, prompting his admission to a treatment center in Sierra Leone. [nejm.org]
These include the following: confusion or inability to think clearly nausea and vomiting red dots that appear on the skin reduced urine volume inadequate blood flow shock It’s crucial to get to the hospital right away if you or someone else is showing [healthline.com]
Symptoms of septic shock include: feeling dizzy or faint being confused or losing alertness unusual mental changes, including a feeling of doom or a fear of death slurred speech diarrhea, nausea, or vomiting severe muscle pain and extreme overall discomfort [medicalnewstoday.com]
Other signs and symptoms for neonatal sepsis include fever in the mother (possible puerperal sepsis due to infection in her reproductive tract) at time of delivery, cloudy or smelly amniotic fluid, abnormal vital signs, seizures, and projectile vomiting [medicinenet.com]
- Nausea
Side effects of these drugs include the following: Heart palpitations Increased blood pressure Nausea Nervousness Thrush (infection of the mouth or throat) Tremor Patients who have familial emphysema (alpha-1 antitrypsin deficiency emphysema) may be treated [healthcommunities.com]
Nausea, vomiting, abdominal pain, and nonbloody diarrhea developed on day 7, prompting his admission to a treatment center in Sierra Leone. [nejm.org]
These include the following: confusion or inability to think clearly nausea and vomiting red dots that appear on the skin reduced urine volume inadequate blood flow shock It’s crucial to get to the hospital right away if you or someone else is showing [healthline.com]
Symptoms of septic shock include: feeling dizzy or faint being confused or losing alertness unusual mental changes, including a feeling of doom or a fear of death slurred speech diarrhea, nausea, or vomiting severe muscle pain and extreme overall discomfort [medicalnewstoday.com]
• Gastrointestinal tract: Nausea, vomiting, diarrhea, and ileus. • Heart: Cardiac output is initially normal or elevated. [atsu.edu]
Cardiovascular
- Cyanosis
This compares with the hypercapnoea and cyanosis of chronic bronchitis with patients referred to as "blue bloaters". In practice, features of these two syndromes coexist as chronic obstructive pulmonary disease. [radiopaedia.org]
Other findings include wheezing, cough, chest pain, cyanosis, and increased heart rate. Emphysema is a chronic medical condition. [visualdx.com]
Cyanosis .—As the disease progresses and the right ventricle becomes involved, the patient takes on a cyanotic appearance. [henriettes-herb.com]
- Heart Disease
A premature infant with arachnodactyly and congenital cyanotic heart disease had severe pulmonary emphysema, a little-known manifestation of Marfan syndrome. The possible etiologies of emphysema in this syndrome are discussed. [ncbi.nlm.nih.gov]
Newsletters These in-depth electronic publications cover major health topics, including men's and women's health, diabetes, and heart disease. [novanthealth.org]
[…] function and rule out heart disease There is no cure for emphysema. [healthline.com]
Heart failure and chronic obstructive pulmonary disease: An ignored combination? Eur J of Heart Fail. 2006;8(7):706-711. Back To Top [appliedradiology.com]
Urogenital
- Cesarean Section
OMJ. 25, (2010); doi:10.5001/omj.2010.42 CASE REPORT A male baby was born to a gravida 4, para 3 mother, at 34wks gestation by emergency lower segment cesarean section. [omjournal.org]
Neurologic
- Hyperactivity
Medicines regulation (16) Toxicology Unwanted effects / adverse reactions (13) Psychiatry Adjustment disorders Alcohol-related disorders Anxiety disorders (including OCD and PTSD) (10) Child and adolescent psychiatry Asperger syndrome (2) Attention-deficit hyperactivity [ep.bmj.com]
[…] causes of chronic obstructive pulmonary disease are: Prolonged exposure to air pollution, such as that seen with burning coal or wood and with industrial air pollutants Infectious diseases: Infectious diseases that destroy lung tissue in patients with hyperactive [medicinenet.com]
Workup
PIE is a radiographic and pathologic diagnosis (see image below and Workup). The introduction of surfactant and newer ventilator modalities has decreased the incidence of PIE. [emedicine.medscape.com]
Developments in the 20th century included the widespread use of spirometry (see Workup ), recognition of airflow obstruction as a key factor in determining disability, and the improvement of pathologic methods to assess emphysema. [emedicine.com]
The laboratory workup of a patient with bullous emphysema is not standardized, but it may include the following considerations: Particularly in those with disease onset at a young age ( alpha-1 antitrypsin level and phenotype may be considered in basilar-predominant [clinicaladvisor.com]
X-Ray
- Atelectasis
Because the donor was marginal (pneumonia in the right lung and lobar atelectasis in both lungs), all recipient candidates with ABO blood group identical declined. Thus, a nonidentical, compatible recipient had a chance to receive a lung transplant. [ncbi.nlm.nih.gov]
[…] developed pneumothorax without lobar atelectasis, and 58% experienced target lobe volume reduction. [pulmonologyadvisor.com]
It appears from their observations that bronchial obstruction is a frequent if not constant phenomenon in atelectasis and emphysema. [jamanetwork.com]
Presence of atelectasis adjacent to a giant bulla (defined as bullae occupying >30% of affected hemithorax); this suggests a favorable prognosis with surgical intervention. [clinicaladvisor.com]
[…] acute bronchitis viêm phế quản cấp acute respiratory distress syndrome hội chứng suy hô hấp cấp tiến triển asthma hen atelectasis xẹp phổi bronchiectasis giãn phế quản bronchopneumonia viêm phế quản - phổi chronic bronchitis viêm phế quản mạn emphysema [memrise.com]
- Mediastinal Shift
Increased intrapleural pressure caused over-expansion of the chest wall and the depression of the diaphragm without much mediastinal shifting. Partial collapse of emphysematous lobes demonstrated bullae that were not previously obvious. [ncbi.nlm.nih.gov]
On imaging, it classically presents on chest radiographs as a hyperlucent lung segment with overinflation and contralateral mediastinal shift. Congenital lobar overinflation is more common in males (M: F = 3:1) 5. [radiopaedia.org]
This air accumulation leads to cystic air spaces with hyperinflation of one lung and a mediastinal shift with associated contralateral lung volume loss (chest radiograph, A; computed tomography scan, B). [anesthesiology.pubs.asahq.org]
shift to right, (Fig. 3). [omjournal.org]
P Wave
- P Pulmonale
With development of cor pulmonale, the following additional changes are seen: Right atrial enlargement (P pulmonale) Right ventricular hypertrophy 3. [lifeinthefastlane.com]
Treatment
WILBUR SHUFF UNDERGOES TREATMENT FOR EMPHYSEMA. POLLUTED AIR IS AN ACUTE PROBLEM FOR HIM - NARA - 545478.jpg 2 016 × 3 000; 939 KB FORMER MACHINIST MR. WILBUR SHUFF UNDERGOES TREATMENT FOR EMPHYSEMA. [commons.wikimedia.org]
The independent lung respiratory treatment lasted 35 and 25 days, respectively: to our knowledge, these are among the longest-lasting independent respiratory treatments reported. [ncbi.nlm.nih.gov]
Prognosis
After discussing with his parents the grave prognosis for neonatal Marfan syndrome, he was discharged home with oxygen treatment and died at home at age 4.5 months. [ncbi.nlm.nih.gov]
Life Expectancy Some information is available on prognosis in COPD patients, but it is limited. Traditionally, prognosis has been reported based on the FEV1, which is a part of PFT. [netwellness.org]
Etiology
The possible etiologies of emphysema in this syndrome are discussed. [ncbi.nlm.nih.gov]
The etiological diagnosis is of basic importance in patients with emphysema because the distinction between primary and secondary types decides the plan of treatment. [jamanetwork.com]
Etiology ARCL1 is genetically heterogeneous and, although the etiology remains unknown in the majority of cases, mutations have been identified in some patients in the FBLN5 (14q31) and EFEMP2 (11q13) genes, encoding the extracellular matrix proteins [orpha.net]
[…] other possible etiologies, e.g. an immunocompromised patient (Figure 6). [appliedradiology.com]
[…] progressive process manifested clinically by dyspnea, which most commonly makes its appearance in middle-aged or elderly males who have had no previous localized or diffuse chronic pulmonary disease and which has generally been regarded as of unknown etiology [nejm.org]
Epidemiology
Details about this forecast and other discussions of sepsis epidemiology can be found in the EpiCast Report: Sepsis and Septic Shock – Epidemiology Forecast to 2026 and the EpiCast Model: Sepsis and Septic Shock – Epidemiology Forecast to 2026. [hospitalmanagement.net]
Clinical trials (epidemiology) (76) Epidemiologic studies (138) Population trends Screening (epidemiology) (66) Survey techniques Therapeutic trials (1) Time-to-event methods Ethics Artificial and donated transplantation (9) Assisted dying Bioethics [ep.bmj.com]
Glomerular filtration rates (eGFRs) were estimated using the method of the Chronic Kidney Disease Epidemiology Collaboration. Quantitative determinants of emphysema and airway dimension were measured from multidetector chest CT scans. [ncbi.nlm.nih.gov]
Berlin, Germany; 2Department of Internal Medicine/Infectious and Respiratory Disease, Charité Universitätsmedizin Berlin, Berlin, Germany; 3Institute for Medical Image Computing, Fraunhofer MEVIS, Bremen, Germany; 4Institute of Biometrics and Clinical Epidemiology [dovepress.com]
Pathophysiology
Functional information of the lungs is important to understand the pathophysiology of emphysema and that of chronic obstructive pulmonary disease. [ncbi.nlm.nih.gov]
Chronic obstructive pulmonary disease (COPD) is a mixture of three separate disease processes that together form the complete clinical and pathophysiological picture. These processes are chronic bronchitis, emphysema and, to a lesser extent, asthma. [emedicine.com]
Fraunhofer MEVIS, Bremen, Germany; 4Institute of Biometrics and Clinical Epidemiology, Charité Universitätsmedizin Berlin, Berlin, Gemany Purpose: Quantitative analysis of CT scans has proven to be a reproducible technique, which might help to understand the pathophysiology [dovepress.com]
Prevention
The alveolar capillary network could initially prevent enlargement of the fenestrae, and the thick elastic fibers constituting the alveolar framework could secondarily prevent destruction of the alveolar wall structure. © 2014 Wiley Periodicals, Inc. [ncbi.nlm.nih.gov]
How can I prevent pulmonary interstitial emphysema? Preventing preterm birth may help prevent PIE. [lluch.org]
COPD (chronic obstructive pulmonary disease) is a common preventable and treatable disease of the lungs. [uofmhealth.org]
Treatments include inhalers, oxygen, medications and sometimes surgery to relieve symptoms and prevent complications.* *Courtesy: National Institutes of Health Find a Pulmonary Specialist [healthcare.utah.edu]