Pulmonary Emphysema

Pulmonary Hyperinflation (Emphysema): Medical History

Medical history (history of illness) is an important component in the diagnosis of emphysema (pulmonary hyperinflation). Family history Is there a history of lung disease in your family? Social history What is your profession? Are you exposed to harmful working substances (gases, dusts) in your profession? Current anamnesis/systemic anamnesis (somatic and psychological complaints). What symptoms … Pulmonary Hyperinflation (Emphysema): Medical History

Pulmonary Hyperinflation (Emphysema): Or something else? Differential Diagnosis

Respiratory System (J00-J99). Bronchial asthma Bronchiectasis (synonym: bronchiectasis) – persistent irreversible saccular or cylindrical dilatation of the bronchi (medium-sized airways) that may be congenital or acquired; symptoms: chronic cough with “mouthful expectoration” (large-volume triple-layered sputum: foam, mucus, and pus), fatigue, weight loss, and decreased exercise capacity Bronchiolitis – inflammation of the small bronchi. Chronic rhinosinusitis … Pulmonary Hyperinflation (Emphysema): Or something else? Differential Diagnosis

Pulmonary Hyperinflation (Emphysema): Complications

The following are the most important diseases or complications that may be contributed to by emphysema (pulmonary hyperinflation): Respiratory system (J00-J99) Respiratory insufficiency – inability of adequate gas exchange. Recurrent (recurring) respiratory tract infections. Pneumothorax – collapse of the lungs due to the presence of air in the gap between the lung and pleura. Cardiovascular … Pulmonary Hyperinflation (Emphysema): Complications

Pulmonary Hyperinflation (Emphysema): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin, mucous membranes, and sclerae (white part of the eye) [barrel thorax (shape of chest resembles a barrel), drumstick fingers (conspicuous thickening of terminal phalanges), watch glass nails (bulging … Pulmonary Hyperinflation (Emphysema): Examination

Pulmonary Hyperinflation (Emphysema): Test and Diagnosis

1st-order laboratory parameters-obligatory laboratory tests. Determination of alpha-1-antitrypsin – should be performed especially in younger and nonsmoking individuals. Laboratory parameters of the 2nd order – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification. Small blood count Differential blood count Inflammatory parameters – CRP (C-reactive protein) … Pulmonary Hyperinflation (Emphysema): Test and Diagnosis

Pulmonary Hyperinflation (Emphysema): Therapy

General measures Nicotine restriction (refraining from tobacco use). Avoidance of environmental pollution: By air pollutants such as various gases, dusts. Travel recommendations: Participation in a travel medical consultation required! Air travel only with an additional oxygen supply Vaccinations The following vaccinations are advised, as infection can often lead to worsening of the present disease: Flu … Pulmonary Hyperinflation (Emphysema): Therapy

Pulmonary Hyperinflation (Emphysema): Drug Therapy

Therapeutic target Improvement of the symptomatology Therapy recommendations In emphysema, analogous to COPD, the following staged regimen is used depending on the exact extent: Inhaled broncho-dilators (drugs that dilate the bronchi). If needed Inhaled broncho-dilatorsas continuous therapy. Inhaled glucocorticoids (synonym: inhaled steroids, ICS). Oxygen therapyup to 16-24 h/d Grade 1 (light) + – – – … Pulmonary Hyperinflation (Emphysema): Drug Therapy

Pulmonary Hyperinflation (Emphysema): Diagnostic Tests

Mandatory medical device diagnostics. Pulmonary function test – to determine pulmonary parameters. X-ray of the thorax (X-ray thorax/chest), in two planes – for initial diagnosis of emphysema Optional medical device diagnostics – depending on the results of the history, physical examination and mandatory laboratory parameters – for differential diagnosis. Computed tomography of the thorax/chest (thoracic … Pulmonary Hyperinflation (Emphysema): Diagnostic Tests

Pulmonary Hyperinflation (Emphysema): Surgical Therapy

In selected cases, surgical lung volume reduction (LVR) is necessary to improve lung function. The procedure is performed surgically or bronchoscopically (endoscopic lung volume reduction, ELVR). Endoscopic lung volume reduction (ELVR) – removal of 20-30% of lung tissue in emphysema. Indication: advanced emphysema with an FEV1 (forced one-second capacity) of <40% and a residual volume … Pulmonary Hyperinflation (Emphysema): Surgical Therapy

Pulmonary Hyperinflation (Emphysema): Prevention

To prevent emphysema (pulmonary hyperinflation), attention must be paid to reducing individual risk factors. Behavioral risk factors Inhalant pollutants such as nicotine – tobacco (smoking). Environmental pollution – intoxications (poisonings). Air pollutants Various gases, dusts (esp. quartz). Ozone and nitrogen oxides To prevent the progression of emphysema, the following measures should be implemented: Regular respiratory … Pulmonary Hyperinflation (Emphysema): Prevention

Pulmonary Hyperinflation (Emphysema): Symptoms, Complaints, Signs

The following symptoms and complaints may indicate emphysema (pulmonary hyperinflation): Dyspnea (shortness of breath) – increases as the disease progresses. Fassthorax (shape of chest resembles a barrel) with: Distended clavicle pits ribs running horizontally Inspiratory (“when breathing in”) retractions in the flank area. Small respiratory volumes Polyglobulia – excessive increase in the number of erythrocytes … Pulmonary Hyperinflation (Emphysema): Symptoms, Complaints, Signs

Pulmonary Hyperinflation (Emphysema): Causes

Pathogenesis (disease development) Pulmonary emphysema predominantly develops as a consequence of chronic obstructive pulmonary disease (COPD). According to the protease/antiprotease concept, inflammatory changes occur, leading to protease overgrowth. These proteases cause congestion of the lungs. Furthermore, with advancing age, there is an enlargement of the air spaces distal to the terminal bronchioles (“senile emphysema”). Etiology … Pulmonary Hyperinflation (Emphysema): Causes