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Chronic obstructive pulmonary disease

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of COPD -- emphysema and/or chronic bronchitis.

Alternative Names

COPD; Alpha-1 antitrypsin deficiency; Bronchitis - chronic; Chronic bronchitis; Emphysema

Symptoms

The hallmark symptom of chronic obstructive lung disease is progressive shortness of breath, frequently accompanied by a phlegm-producing cough, with episodes of wheezing. Symptoms may vary, however, or others may be present depending on which disease predominates.

Symptoms of Emphysema

Typically, first symptoms of emphysema occur in heavy smokers in their mid-50s. Emphysema patients have typically lost between 50 - 70% of their lung tissue by the time symptoms begin to appear:

• The predominant early symptom is shortness of breath with light physical activity. Coughing is usually minor, and there is little sputum (phlegm).
• Late, severe symptoms include rapid, labored breathing and persistent air hunger even during rest or after minimal physical activity.
• People with severe emphysema tend to have pinkish skin and barrel-shaped chests due to overinflated lungs (lungs that are bigger than normal size, due to lost elasticity and trapped air).
• In some cases, involuntary weight loss may be a symptom of emphysema.

Symptoms of A1AD-related emphysema tend to appear between the ages of 30 and 40. As with standard emphysema, they include shortness of breath after physical activity, wheezing, and inability to exercise.

Symptoms of Chronic Bronchitis

Chronic bronchitis usually causes the following symptoms:

• Coughing with excessive sputum on most days for at least 3 months of the year, over 2 successive years -- these symptoms in this time frame are the standard minimums for a diagnosis.
• Shortness of breath occurs, but it may not be as severe during rest as it is in emphysema.
• Lying down at night worsens symptoms in advanced conditions, so patients must sleep sitting up.

In late, severe stages, lack of oxygen causes the skin to have a blue cast (cyanosis), and the body is swollen from fluid accumulation caused by congestive heart failure. Such patients often have emphysema as well.

• Review Date: 4/28/2006
• Reviewed By: Harvey Simon, M.D., Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

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