Chronic Obstructive Pulmonary Disease and Emphysema
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.
Epidemiology
Incidence
The incidence of COPD is 8.9/1,000 person-years.
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
- 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
There's more to see -- the rest of this topic is available only to subscribers.
Citation
Domino, Frank J., et al., editors. "Chronic Obstructive Pulmonary Disease and Emphysema." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116133/3.4/Chronic_Obstructive_Pulmonary_Disease_and_Emphysema.
Chronic Obstructive Pulmonary Disease and Emphysema. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116133/3.4/Chronic_Obstructive_Pulmonary_Disease_and_Emphysema. Accessed December 2, 2023.
Chronic Obstructive Pulmonary Disease and Emphysema. (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116133/3.4/Chronic_Obstructive_Pulmonary_Disease_and_Emphysema
Chronic Obstructive Pulmonary Disease and Emphysema [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 December 02]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116133/3.4/Chronic_Obstructive_Pulmonary_Disease_and_Emphysema.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Chronic Obstructive Pulmonary Disease and Emphysema
ID - 116133
ED - Domino,Frank J,
ED - Baldor,Robert A,
ED - Golding,Jeremy,
ED - Stephens,Mark B,
BT - 5-Minute Clinical Consult, Updating
UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116133/3.4/Chronic_Obstructive_Pulmonary_Disease_and_Emphysema
PB - Wolters Kluwer
ET - 27
DB - Medicine Central
DP - Unbound Medicine
ER -