Chronic Obstructive Pulmonary Disease and Emphysema

Chronic Obstructive Pulmonary Disease and Emphysema is a topic covered in the 5-Minute Clinical Consult.

To view the entire topic, please or .

Medicine Central™ is a quick-consult mobile and web resource that includes diagnosis, treatment, medications, and follow-up information on over 700 diseases and disorders, providing fast answers—anytime, anywhere. Explore these free sample topics:

-- The first section of this topic is shown below --

Basics

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 (2).

Epidemiology

Incidence
The incidence of COPD is 8.9/1,000 person-years.

Etiology and Pathophysiology

Exposure to noxious gases or particles (see “Risk Factors”) leading to the following pathologic processes in the lung:

  • Impaired gas (carbon dioxide and oxygen) exchange
  • Persistent airway obstruction
  • Destruction of lung parenchyma

Genetics

  • Genetics may contribute to host response to noxious gases or particles.
  • Antiprotease deficiency (due to α1-antitrypsin deficiency) is an inherited, rare disorder due to two autosomal codominant alleles.

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

Smoking cessation—and general avoidance of noxious material—is the most important preventative measure.

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
  • Miscellaneous: malnutrition, osteoporosis, muscle dysfunction, depression

-- To view the remaining sections of this topic, please or --

Basics

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 (2).

Epidemiology

Incidence
The incidence of COPD is 8.9/1,000 person-years.

Etiology and Pathophysiology

Exposure to noxious gases or particles (see “Risk Factors”) leading to the following pathologic processes in the lung:

  • Impaired gas (carbon dioxide and oxygen) exchange
  • Persistent airway obstruction
  • Destruction of lung parenchyma

Genetics

  • Genetics may contribute to host response to noxious gases or particles.
  • Antiprotease deficiency (due to α1-antitrypsin deficiency) is an inherited, rare disorder due to two autosomal codominant alleles.

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

Smoking cessation—and general avoidance of noxious material—is the most important preventative measure.

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
  • Miscellaneous: malnutrition, osteoporosis, muscle dysfunction, depression

There's more to see -- the rest of this topic is available only to subscribers.