Common Disease Related To Respiratory Disease (COPD)

Here are the most common disease of respiratory system in Malaysia:

1) Chronic Obstructive Pulmonary Disease

2) Tuberculosis

3) Pneumonia

We decide to discuss about Chronic Obstructive Pulmonary Disease first:

Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a common cause of illness in the community associated mainly with cigarette smoking.  It is a progressive disease with considerable morbidity and mortality.

Chronic obstructive pulmonary disease is a condition characterised by persistent airflow obstruction, which is slowly progressive.  It may be partially reversible and there may be features of airway hyperreactivity.  Traditionally, it comprises chronic bronchitis and emphysema.

Chronic bronchitis is defined by the presence of increased bronchial secretions with chronic cough and expectoration on most days for at least 3 months a year in two consecutive years.

Emphysema is defined anatomically by permanent destructive enlargement of airspaces distal to the terminal bronchioles without obvious fibrosis.

Pathology

a)      Chronic bronchitis

Hyperplasia of the secretory cells and mucous gland enlargement are the histological hallmarks of chronic bronchitis, and these are the tissue correlates of increased sputum production.  These changes are due to repeated irritation by pollutants and infections. Airway wall inflammation, stenosis and distortion due to fibrosis may also be present. The small bronchi and bronchioles are the main sites of the increased resistance to airflow.

b)   Emphysema

Two main forms of emphysema are described.Centriacinar emphysema is characterised by focal destruction restricted to respiratory bronchioles and the central portion of an acinus, surrounded by relatively normal lung.  Panacinar emphysema involves destruction of all the air spaces supplied by the terminal bronchiole.  The current view is that emphysema occurs as a result of an imbalance between proteases and anti-protease resulting in a relative increase in proteases and resultant destruction of lung tissue.

Hyperinflation of lungs occur in emphysema and chronic bronchitis.

Findings of hyperinflation are:

• Dark lung fields.
• Low set diaphragm in 11th or 12th posterior rib.
• Heart is vertical and narrow. This is the result of downward push of diaphragm by lungs.
• Flattened diaphragms in lateral chest.
• Infracardiac air: Left diaphragm is seen in its entirety.
• Retrosternal air is increased.
• Increased AP diameter.

What are the x-ray findings of emphysema?

• Lungs are large and hyperinflated.
• Signs of hyperinflation are:
• Low set diaphragm
• Flat diaphragm best determined by lateral chest
• Hyperlucent lung fields
• Increased AP diameter
• Increased retrosternal air
• Vertical heart.
• We can call it emphysema only when hyperinflation is associated with blebs and paucity of vascular markings in the outer third of the film.
  

Complication

• Respiratory infection
• Cor pulmonale
• Pulmonary hypertension
• Lung cancer
• Pneumothorax
• Arrhythmias

Allah says:

( ولا تقتلوا أنفسكم (النساء ,29

And do not kill yourselves

(Qur’an 4:29)

Allah also says:

( و لا تلقوا بأيديكم إلى التهلكة (البقرة, 195

And do not throw yourselves into destruction

(Qur’an 2:195)

• Wait for the next release! We will discuss about Tuberculosis. InshaAllah :)