Smoking and particulate matter are the biggest risk factors for developing the chronic lung disease COPD. Shortness of breath and cough with sputum are among the symptoms.COPD initially progresses unnoticed and slowly. At the beginning, sufferers can keep up well on light hikes, but over time they run out of air after the second floor when climbing stairs. If the condition decreases and shortness of breath becomes apparent – often coupled with a chronic cough after standing up – a lung specialist should be consulted. The disease cannot be cured, but it can be alleviated and slowed down. If left untreated, emphysema develops, which significantly reduces life expectancy.
Summary
– COPD results in permanently inflamed bronchi with or without hyperinflated or obstructed airways. damaged pulmonary alveoli (emphysema). – Severity is measured in GOLD stages. – In the advanced stage, the disease affects the entire body. Not only changes in the lungs occur, but also metabolism, immune system and musculature are affected. – COPD is a chronic disease and cannot be cured. – Drug treatment can relieve symptoms, and respiratory therapy can make it easier to breathe and manage shortness of breath.
COPD at a glance
chronic lung disease
Smoking, environmental influences (particulate matter, pollutants), possibly. also genetic predisposition
Shortness of breath, cough with sputum, breath sounds, emphysema
Smoking cessation, occupational safety measures, symptomatic treatment, long-term oxygen therapy
What is COPD? The abbreviation COPD comes from the English. Stands for chronic obstructive pulmonary disease. COPD is a progressive, severe lung disease in which exercise capacity and lung function are increasingly impaired.
Obstructive pulmonary disease results in constriction and permanent inflammation of the airways, and later sometimes in emphysema (damaged alveoli).
Affected people do not notice it for a long time. The respiratory tract tries to get rid of pollutants by (morning) coughing and increased sputum ("smoker's cough"). Increasing shortness of breath during physical exertion is often described as "lack of stamina dismissed.
In the advanced stage, concomitant diseases may occur, such as very rapid weight loss ("COPD-wasting"), weakening of muscles and immune system, or cor pulmonale ("pulmonary heart"). This occurs when the right heart, which pumps blood from the heart to the lungs, is overloaded. Many sufferers also experience anxiety and depression.
Frequency of COPD
Estimates of the prevalence of COPD vary widely. It is well known that people aged 50 and over are particularly affected.
Causes of COPD
Smoking is by far the greatest risk factor for the development of COPD. In about 80-90% of cases, cigarette smoke causes the disease – either directly or indirectly through passive smoking. Other factors that can promote the development of chronic lung disease include:
– Inhalation of air pollutants (z.B. Cement dust, engine exhaust, chemical fumes) or smoke exposure from stoves and fireplaces – severe, inadequately treated asthma – in very rare cases, a congenital deficiency of a certain protein (alpha-1 antitrypsin deficiency)
COPD and particulate matter
Fine dust in the air affects everyone, so limit values and driving bans are important. They are derived in such a way that even people with lung diseases (e.g., chronic obstructive pulmonary disease) can be treated.B. asthma, COPD) must be protected.
Particulate matter is made up of tiny particles of different sizes and chemical compositions and is the number one air pollutant. 1. It floats in the air we breathe and poses a major challenge to the lungs. If there is occupational exposure, it is essential to comply with occupational health and safety measures.
Tips to combat excessive exposure to particulate matter:
– when walking in the city, seek out natural oases, parks or pedestrian zones – choose bicycle paths that do not run directly next to a busy road – avoid car journeys with your own car as much as possible – sniff alpine air (high-altitude air in the mountains is only very slightly contaminated with fine dust) – largely avoid staying in smoky rooms – ventilate your own home at times when there is little traffic
Symptoms of COPD
The typical symptoms of chronic obstructive pulmonary disease include the "AHA symptoms" shortness of breath, cough, sputum.
cough: The respiratory tract reacts to the constant inflammation with increased mucus production and coughing with mucus (sputum). This occurs mainly in the morning – at first only occasionally, later daily and increasingly during the day – and is one of the first signs of COPD. Shortness of breath: initially during exertion such as running or climbing stairs, later also increasingly at rest. Many sufferers have a high incidence of coughing up expectorant sputum when they smoke-. Exhale sounds like z.B.B. hear humming or whistling ("wheezing"). coldsRespiratory infections, colds or flu may also occur. emphysema: The more the disease progresses, the less the body's oxygen supply is. The lungs become overinflated. Can no longer pass oxygen to the blood. Emphysema cannot be cured or reversed, the affected part of the lung is destroyed. exacerbations (Worsening of symptoms): If left untreated, the condition will continue to worsen with increased coughing and increased shortness of breath. These become more frequent as the disease progresses. Often lead to hospitalization. Usually caused by infections such as bronchitis or influenza.
Diagnosis of COPD
The contact person is the lung specialist (pulmonologist). In the course of a detailed anamnesis, the physician will ask questions about the symptoms, their duration and intensity, the occupation, the smoking behavior and the history of the disease.
This is followed by an examination:
– Lung function measurement (spirometry) is the most important tool for testing for lung disease. Under supervision, the patient breathes through a tube into a device that measures the airflow. The patient may also sit in a kind of glass box (whole-body plethysmography). Medication is used to test how far the narrowing of the airways can be reversed (reversibility test). – An examination of the chest with X-ray or computer tomography helps to detect emphysema and rule out other diseases. – Since the disease also stresses the heart, an ECG (electrocardiogram) may also be done, with or without exercise. – Often the blood is also tested for its oxygen content (blood gas analysis).
GOLD stages
Today, the severity of the disease is divided into GOLD stages A to D. COPD is classified according to the extent of functional impairment (lung function) and the symptom burden or severity of symptoms. the frequency of acute exacerbations (so-called. exacerbations) within one year.
GOLD AVery mild symptoms that often go unnoticed. GOLD B: Symptoms increase (z.B. Morning cough, shortness of breath on more strenuous exertion such as walking up stairs, exercising or playing sports), but are still so mild that they are often ignored. GOLD CBreathlessness with even light exertion, such as normal climbing of stairs, short runs or walking uphill. Cough and sputum increase. GOLD D: Severe shortness of breath, already even at rest. The patient requires long-term oxygen therapy; performance and quality of life are severely limited.
For a long time, lung function was the only criterion for determining the severity of COPD. With the current GOLD guidelines, exacerbations also play a major role: a single hospital-treated exacerbation is enough to classify that person as a high-risk COPD patient.
Therapy of COPD
A cure for COPD is not possible. However, early initiation of treatment is important to improve lung function. In addition to drug therapies and long-term oxygen therapy, there are also non-drug measures that can significantly improve the quality of life. If respiratory function is already severely impaired and the body receives too little oxygen, long-term oxygen therapy is used.
COPD and COVID-19
COPD patients have an increased risk of a severe course in case of infection with SARS-CoV-2. Due to COPD, the lungs are already chronically inflamed and the immune system is weakened. In addition to COPD, other risk factors such as age, previous cardiovascular disease or tobacco consumption also play a role. Affected persons and their relatives should therefore take the situation seriously, wear FFP2 masks and observe hygiene measures.
COPD: What can sufferers do in addition??
– The first step for smokers is to stop smoking. – Those with a heavy workload should try to find a less stressful job. – Regular exercise promotes the function of the lungs as well as the heart and the circulation. Endurance sports such as running, cycling, swimming or Nordic walking are particularly suitable for this purpose. – Pay attention to the right weight. Excess weight literally makes life difficult and puts additional strain on the heart and circulatory system. Underweight, on the other hand, weakens the body. Makes him susceptible to infections. – With the help of a respiratory physiotherapist, the patient learns how to deal with shortness of breath and coughing. against influenza and pneumococci can protect against exacerbations. – Psychological problems, fears or depressive moods should be discussed with those around you and, if necessary, professional help should be sought.
Listen to MeinMed
Audio: Silent widespread disease COPD: An update on treatment options
Speaker: Univ.-Prof. Dr. Med. univ. Horst Olschewski (Graz, 5.3.2020)
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