Chronic Obstructive Pulmonary Disease and Emphysema
Basics
Basics
Basics
Description
Description
Description
- The Global Initiative for Chronic Obstructive Lung Disease (GOLD) defines COPD as follows:
- “COPD is a common, preventable, and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases and influenced by host factors including abnormal lung development” (1).
- This new definition no longer includes the terms “emphysema” and “chronic bronchitis.”
- COPD is now the third leading cause of death worldwide, with 90% of these deaths occurring in low- and middle-income countries. COPD was responsible for 3.2 million deaths globally in 2019.
Epidemiology
Epidemiology
Epidemiology
Incidence
The incidence of COPD is 8.9/1,000 person-years.
Etiology and Pathophysiology
Etiology and Pathophysiology
Etiology and Pathophysiology
Exposure to noxious gasses or particles leading to pathologic processes in the lung:
- Impaired gas (carbon dioxide [CO2] and oxygen) exchange, persistent airway obstruction, destruction of lung parenchyma
Genetics
α1-Antitrypsin deficiency is a rare inherited disorder due to two autosomal codominant alleles.
Risk Factors
Risk Factors
Risk Factors
- Smoking tobacco or marijuana: including passive smoking and water pipe
- History of severe childhood respiratory infections
- Aging—including healthy aging as well as the cumulative summation of lung exposure over time
- Lower level of education and lower socioeconomic status
- Asthma and airway hyperreactivity
- Indoor air pollution (especially indoor biomass cooking worldwide)
- Occupational organic or inorganic dusts
General Prevention
General Prevention
General Prevention
Smoking cessation and general avoidance of noxious material is the most important preventative measure.
Commonly Associated Conditions
Commonly Associated Conditions
Commonly Associated Conditions
- Pulmonary: lung cancer, chronic respiratory failure, acute bronchitis, sleep apnea, pulmonary hypertension (HTN), asthma
- Cardiac: coronary artery disease, arrhythmia
- Ear/nose/throat (ENT): chronic sinusitis, laryngeal carcinoma
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