COPD Overview

Introduction

• COPD: Stands for Chronic Obstructive Pulmonary Disease.
• Encompasses diseases like asthma, chronic bronchitis, and emphysema.
• Focus: Comparison between chronic bronchitis and emphysema.

Signs and Symptoms

• Emphysema Patients (Pink Puffers):
  • Difficulty breathing.
  • Well perfused.
  • Barrel chest.
  • Muscle wasting.
  • Pursed lips.
• Chronic Bronchitis Patients (Blue Bloaters):
  • Difficulty breathing.
  • Productive cough.
  • Chest tightness.
  • Peripheral edema.
  • Raised jugular venous pressure (JVP) due to potential right-sided heart failure.

Pathology

• Emphysema:
  • Affects alveoli, the lung's functional units.
  • Loss of elastic fibers in alveoli.
  • Decreased alveolar surface area.
  • Air trapping due to inadequate recoil during exhalation.
• Chronic Bronchitis:
  • Affects airway tract, specifically bronchioles.
  • Smooth muscle hypertrophy and contraction.
  • Mucus hypersecretion.

Risk Factors for COPD

• Smoking.
• Advanced age.
• Low socioeconomic status.
• Genetic predispositions.
• Constant exposure to air pollution.
• Developmentally abnormal lungs.

Diagnostic Investigations

• Chest X-ray:
  • Can show a flattened diaphragm and hyperinflation.
• Spirometry:
  • Measures lung function.
  • Normal vs. COPD spirometry curve.
  • Criteria: FEV1/FVC ratio < 70%.
  • Bronchodilator test to confirm COPD diagnosis.

Management of COPD

• Smoking cessation.
• Use of oxygen in late stages.
• Bronchodilators (B2 agonists or M3 antagonists).
• Steroid inhalers as preventative measures.