Cardiac/Blood/Resp Disease Pulmonary Disease

Pulmonary Disease

What is pulmonary disease?

Chronic obstructive pulmonary disease (COPD), also known as chronic obstructive lung disease (COLD), and chronic obstructive airway disease (COAD), among others, is a type of obstructive lung disease characterized by chronically poor airflow. It typically worsens over time. The main symptoms include shortness of breath, cough, and sputum production.^[1] Most people with chronic bronchitis have COPD.

What are the symptoms?

The symptoms of pulmonary vascular disease vary according to several factors:

• The suddenness of the process affecting the pulmonary blood vessels
• Which pulmonary blood vessels are affected (where the pulmonary vascular disease is)
• How much of the pulmonary vascular system is affected

 Large pulmonary embolism blocking a large pulmonary artery can cause severe shortness of breath and chest pain. But a very small pulmonary embolism (blocking only a small blood vessel) may cause no noticeable symptoms.

Although symptoms of pulmonary vascular disease can vary widely, each of the causes of pulmonary vascular disease has a set of usual symptoms:

Pulmonary arterial hypertension: This most often causes slowly progressive shortness of breath. As the condition worsens, chest pain or fainting (syncope) with exertion can occur.

Pulmonary embolism: A blood clot to the lungs typically occurs suddenly. Shortness of breath, chest pain (often worse with deep breaths), and a rapid heart rate are common symptoms. Pulmonary embolism symptoms range from barely noticeable to severe, based on the size of the blood clot(s).

Pulmonary venous hypertension: This form of pulmonary vascular disease also causes shortness of breath, due to the congestive heart failure that's usually present. Shortness of breath may be worse while lying flat, when blood pressure is uncontrolled, or when extra fluid is present (edema).

Causes of pulmonary disease

Pulmonary vascular disease is divided into several categories:

Pulmonary Arterial Hypertension: Increased blood pressure in the pulmonary arteries (carrying blood away from the heart to the lungs). Pulmonary arterial hypertension can be caused by lung disease,autoimmune disease, or heart failure. When there is no apparent cause, it's called idiopathic pulmonary arterial hypertension.

Pulmonary Venous Hypertension: Increased blood pressure in the pulmonary veins (carrying blood away from the lungs, to the heart). Pulmonary venous hypertension is most often caused by congestive heart failure. A damaged mitral valve in the heart (mitral stenosis ormitral regurgitation) may contribute to pulmonary venous hypertension.

Pulmonary Embolism: A blood clot breaks off from a deep vein (usually in the leg), travels into the right heart, and is pumped into the lungs. Rarely, the embolism can be a large bubble of air, or ball of fat, rather than a blood clot.

Chronic Thromboembolic Disease: In rare cases, a blood clot to the lungs (pulmonary embolism) is never reabsorbed by the body. Instead, a reaction occurs in which multiple small blood vessels in the lungs also become diseased. The process occurs slowly, and gradually affects a large part of the pulmonary arterial system.

When should you get tested for the disease?

The diagnosis of pulmonary vascular disease is usually made using one or more of the following tests:

Computed tomography (CT scan): A CT scanner takes multiple X-rays, and a computer constructs detailed images of the lungs and chest. CT scanning can usually detect a pulmonary embolism in a pulmonary artery. CT scans can also uncover problems affecting the lungs themselves.

Ventilation/perfusion scan (V/Q scan): This nuclear medicine test takes images of how well the lungs fill with air. Those images are compared to pictures of how well blood flows through the pulmonary blood vessels. Unmatched areas may suggest a pulmonary embolism (blood clot) is present.