User:Scohoust/Sandbox
- Note: COPD may also refer to RAOin horses.
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Chronic obstructive pulmonary disease (COPD) is a group of
Signs and symptoms
The main
COPD is particularly characterised by a ratio of forced expiratory volume over 1 second (FEV1) to forced vital capacity (FVC) being < 70% and the FEV1 < 80% of the predicted value.[3] Other signs include a rapid breathing rate (tachypnea) and a wheezing sound heard through a stethoscope.
Causes
The leading cause of COPD is smoking. Continuous smokers have at least a 25% risk of developing COPD.[4] Working or living in a polluted environment is a possible cause of COPD. For example, many people develop COPD after working in the coal mining industry and being exposed to high levels of respirable coal dust.
Rarely, there may be a deficiency in an
Pathophysiology
Chronic Bronchitis
Chronic bronchitis is defined in clinical terms as a cough with sputum production on most days for 3 months of a year, for 2 consecutive years.[6]
Chronic bronchitis is hallmarked by the increased number (
Emphysema
Emphysema is defined
The enlarged air sacs (
Diagnosis
The diagnosis of COPD is usually suggested by symptoms; it is a clinical diagnosis and no single test is definitive. A comprehensive history from the patient (particularly related to smoking), physical examination, and confirmation of airflow obstruction using spirometry (see above) are all vital in establishing the diagnosis.
The severity of COPD can be classified through spirometry:
Severity | Post-bronchodilator FEV1/FVC | FEV1 % predicted |
---|---|---|
At risk | >0.7 | ≥80 |
Mild COPD | ≤0.7 | ≥80 |
Moderate COPD | ≤0.7 | 50-80 |
Severe COPD | ≤0.7 | 30-50 |
Very Severe COPD | ≤0.7 | <30 |
Management
Although COPD is not curable, it can be controlled in a variety of ways.
Smoking cessation
Smoking cessation is one of the most important factors in slowing down the progression of COPD. Even at a late stage of the disease it can reduce the rate of deterioration and prolong the time taken for disability and death.[7]
Drug therapy
Bronchodilators
There are three types of
Corticosteriods
Inhaled
Vaccination
Patients with COPD should be routinely vaccinated against influenza to prevent illness and the possibility of death.[8]
Pulmonary rehabilitation
Pulmonary rehabilitation is a programme of disease management, counselling and exercise coordinated to benefit the individual.[9] Pulmonary rehabilitation has been shown to relieve difficulties breathing and fatigue. It has also been shown to improve the sense of control a patient has over their disease as well as their emotions.[10]
Prognosis
A good prognosis of COPD relies on an early diagnosis and prompt treatment. Most patients will have improvement in lung function once treatment is started, however eventually signs and symptoms will worsen as COPD progresses. The median survival is about 10 years if two-thirds of expected lung function was lost by diagnosis.[11]
Epidemiology
According to the
Since COPD is not diagnosed until it becomes clinically apparent, prevelance and mortality data greatly underestimate the socio-economic burden of COPD.[8] In the UK, COPD accounts for about 7% of all days of sickness related absence from work.[7]
References
- PMID 16690673
- ^ U.S. National Heart Lung and Blood Institute - Signs and Symptoms
- ^ PatientPlus - Spirometry
- PMID 17071833
- ^ MedlinePlus Medical Encyclopedia
- ^ ISBN 0-19-852558-3.
- ^ ISBN 0702027634.
- ^ a b c American Thoracic Society / European Respiratory Society Task Force (2005). Standards for the Diagnosis and Management of Patients with COPD. Version 1.2. New York: American Thoracic Society. http://www.thoracic.org/go/copd
- ^ U.S. National Heart Lung and Blood Institute - Treatment
- PMID 12137716
- ^ Prognosis of COPD
- ^ WHO - COPD