Pulmonary

Alpha-1 Antitrypsin Deficiency

Alpha-1 Antitrypsin (AAT) Deficiency is a hereditary condition that primarily affects the lungs. ATT is a protein produced by the liver and found in the blood. This protein circulates through the blood and protects the lungs and other organs, allowing them to function properly. If the body does not produce enough AAT, the lungs can become damaged over time leading to chronic lung diseases as noted below.

Asthma

Asthma is a chronic condition of the lungs which leads to excess mucus production, inflammation, and narrowing of the airways. Asthma attacks, also known as exacerbations, can be triggered by a variety of causes including but not limited to allergens, exercise, and irritants such as cigarette smoke and pollution. During an asthma attack the bands of muscle around the airways tighten making it difficult to breathe. Exacerbations can range from mild, lasting only a few minutes, to severe or even life-threatening which require seeking prompt medical attention.

Symptoms of asthma vary including coughing, wheezing, shortness of breath, and chest pain. Asthma is managed by limiting known triggers as well as managing symptoms with medications including inhalers and oral steroids aimed at reducing airway inflammation.

Bronchitis

Bronchitis is the result of inflammation and swelling in the bronchial tubes (airways) which carries air to and from the lungs. There are two types of bronchitis: Acute and Chronic.

Acute Bronchitis – This form of bronchitis is common and typically caused by viral infections such as Influenza, COVID, and RSV. The most common symptom is a sudden onset and persistent cough usually lasting less than three weeks. Other symptoms may include shortness of breath, wheezing, chest congestion, low grade fever, sore throat, and runny nose. It is not uncommon to experience a lingering cough for several weeks even after other symptoms resolve.

Chronic Bronchitis – This form of bronchitis is defined as a cough lasting several months and reoccurring over consecutive years. It is also a component of COPD. Common causes include smoking or exposure to secondhand smoke, air pollution, chemical fumes, and dust over prolonged periods of time.

Chronic Cough (Bronchiectasis)

An occasional cough is one defense mechanism for the body's immune system to stay healthy by helping clear irritants and secretions that may carry infections to the lungs. However, a cough lasting eight weeks or longer in adults, or four weeks in children is classified as a chronic cough. This is the type of cough that can interrupt sleep, cause lightheadedness, induce vomiting, or fracture ribs in severe cases.

Several common issues can cause a chronic cough, such as smoking, Asthma, Gastroesophageal Reflux Disease, COPD, postnasal drip, and various infections. In most cases, a chronic cough will go away once the underlying cause is discovered and treated.

Chronic Obstructive Pulmonary Disease (COPD)

Chronic Obstructive Pulmonary Disease (COPD) is a long-term lung disease that causes airflow limitation making it difficult to breathe. It commonly includes both chronic bronchitis and emphysema, whether on their own or combined. COPD is a progressive disease and the damage it causes cannot be reversed. However, it is treatable; and with proper management, most people can manage symptoms and retain a good quality of life.

COPD affects millions of Americans and is in the top five of disease-related deaths in the United States. The most common cause of COPD is smoking. Signs of chronic obstructive pulmonary disease include:

  • Prolonged cough that may produce mucus
  • Wheezing
  • Shortness of breath, even from regular activities or mild exercise
  • Difficulty breathing
  • Tight chest
  • Recurrent respiratory infections

Episodes called “exacerbations” are common with COPD. This is when symptoms become acutely worse and may require a change in medication or even a hospital stay.

COPD can be managed with medications that focus on relieving the symptoms of coughing and difficulty of breathing, as well as preventing respiratory infections. As there are several different types of medication, it is best to talk to your provider and find out the best course of treatment for you.

Interstitial Lung Disease

Interstitial Lung Disease (ILD) refers to a group of lung disorders that causes prolonged inflammation of the lung tissue leading to scarring and stiffening known as fibrosis. This scarring makes it difficult for oxygen to be delivered to the bloodstream and can precipitate (trigger?) shortness of breath. Causes of interstitial lung disease include, but are not limited to, the following:

  • Medical Conditions – Autoimmune disease such as Rheumatoid arthritis, Scleroderma, Lupus, Polymyositis/Dermatomyositis, Sjogren’s syndrome, and Sarcoidosis can result in ILD.
  • Medications - Some chemotherapy treatments, heart medications, antibiotics, and anti-inflammatory drugs may cause ILD.
  • Environmental Factors – Prolonged exposure to harmful substances such as coal dust, tobacco, asbestos, grain dust, silica dust, radiation and even hairdressing chemicals may cause ILD.
  • Idiopathic ILD - This term is used when the cause is unknown. Some common causes of idiopathic ILD include idiopathic interstitial pneumonias.

The most common symptoms of ILD include shortness of breath and a dry non-productive cough. Treatments for ILD include medications, oxygen therapy, pulmonary and exercise therapy, and, in extreme cases, lung transplant. ILD can lead to serious complications such as high blood pressure, right-sided heart failure (cor pulmonale), and respiratory failure.

Lung Cancer

Lung cancer is the leading cause of cancer deaths in the world. Most cases of lung cancer are caused by smoking or inhaling secondhand smoke. However, there are cases that have occurred in people that have never smoked or been exposed to secondhand smoke.

There are two main types of lung cancer:

  • Non-small cell lung cancer (NSCLC) is more common and is a term that covers several subtypes of lung cancers.

    • Adenocarcinoma
    • Squamous Cell Carcinoma
    • Large-cell Carcinoma

  • Small cell lung cancer (SCLC) is less common and tends to be very aggressive. It can become advanced and spread quickly to other organs of the body even before symptoms appear. It accounts for approxiamtely 15% of lung cancers.

Symptoms of lung cancer are not always apparent in the early stages. However, some symptoms may include:

  • Persistent Cough
  • Shortness of breath
  • Hoarseness
  • Coughing up blood
  • Wheezing
  • Bone pain
  • Chest pain

Treatments for lung cancer vary depending on the type and stage of the cancer. Talk with your doctor about Lung Cancer Screening if you are concerned or have a family history of lung cancer.

Occupational Lung Diseases

Occupational lung diseases are lung disorders caused by or made worse from work environments where irritants have been inhaled into the lungs over a long period of time. Types of irritants can include dust, chemicals, bacteria, and mold. These small particles are inhaled into the lungs, and get absorbed into the body. Examples of occupational lung diseases include:

  • Asbestosis
  • Byssinosis
  • Silicosis
  • Black Lung Disease (Coal Workers Pneumoconiosis)
  • Occupational Asthma
  • Hypersensitivity Pneumonitis

Most occupational lung diseases are caused by prolonged continuous exposure. However, a single exposure to certain unsafe materials may cause damage to the lungs as well.

Pneumonia

Pneumonia is an infection in one or both of the lungs due to bacteria, viruses, or fungi. When the lungs become infected, the airways swell and the air sacs in the lungs fill with mucus and/or other fluids. Pneumonia is the second most common reason for being admitted into the hospital, and symptoms can range from mild to severe.

What causes pneumonia?

  • Community-acquired pneumonia – This is the most common form of pneumonia and indicates an individual who became infected in a community setting as opposed to a hospital and other health-care facilities. Common organisms that cause community-acquired pneumonia include:

    • Bacteria – Streptococcus pneumoniae is the most common cause of bacterial pneumonia in the US. It can develop on its own or after a person has had a cold or the flu.
    • Bacteria-like organisms – Other types of bacteria can cause different types of pneumonia. For example, Mycoplasma pneumoniae causes what is known informally as Walking Pneumonia. This type of pneumonia is typically milder and does not require bed rest. Other examples include Legionella pneumoniae and Chlamydia pneumoniae.
    • Viruses – Some viruses that cause colds, the flu, or respiratory infections can cause pneumonia.
    • Fungi/Molds – Fungi and mold found in bird droppings or soil in certain regions can cause pneumonia if inhaled.

  • Hospital-acquired pneumonia – Hospital-acquired pneumonia is pneumonia that develops while the patient is in the hospital receiving treatment for another illness. This type of pneumonia is typically more severe because the bacteria causing the infection can be more resistant to antibiotics.
  • Health-care acquired pneumonia – This type of pneumonia is acquired by people that live in long-term care facilities or attend outpatient care clinics for treatment. Like hospital-acquired pneumonia, the bacteria can be more resistant to antibiotics, causing the infection to be more severe.
  • Aspiration pneumonia – Aspiration pneumonia occurs when solid food, vomit, liquid or saliva is inhaled into the lungs and remains. These particles can become infected and develop into pneumonia.

Symptoms of pneumonia may include:

  • Chest pain when breathing or coughing
  • Fatigue
  • Fever and chills
  • Cough with phlegm/mucus
  • Shortness of breath
  • Confused mental state or changes in awareness
  • Loss of appetite

Treatment for pneumonia varies based on the severity of illness and presumed or known cause. If the cause of pneumonia is suspected or known to be related to a bacterial infection antibiotics may be prescribed. Other treatments are targeted to help relieve symptoms. In severe cases if an individual is not getting enough oxygenation delivered to their lungs because of the infection then supplemental oxygen may be required.

Pulmonary Hypertension

Pulmonary Hypertension is the result of blood vessels in the lungs becoming narrow or blocked leading to slowing of blood flow through the lungs. This causes high blood pressure in the arteries of the lungs and right side of the heart. Over time the heart becomes overworked from the strain of pumping blood into the lungs. This can result in the heart becoming weak and lead to heart failure. Some causes of pulmonary hypertension include left sided heart disease, chronic lung disorders including COPD, thromboembolic diseases, and genetic disorders.

Symptoms of pulmonary hypertension are slow to develop and get worse as the disorder progresses. Symptoms include:

  • Dizziness or passing out
  • Irregular or pounding heartbeat (palpitations)
  • Difficulty breathing at rest
  • Shortness of breath
  • Pressure in the chest

There is no cure for some types of pulmonary hypertension. However, there are treatments that can reduce symptoms and help to maintain a good quality of life.

Sarcoidosis

Sarcoidosis is an inflammatory disease causing small collections of inflamed cells (granulomas) to grow on tissues of the body. The most common areas for granulomas to grow are the lungs, lymph nodes, eyes, and skin. However, any organ or part of the body can be affected, and symptoms vary depending on the organ affected. Sarcoidosis most often involves the lungs and causes symptoms such as shortness of breath, chest pain, and coughing. While there is not a known cause for developing sarcoidosis, it appears to be related to an overactive immune response which then leads to immune cells forming into granulomas on affected organs or tissues of the body. There is no cure for sarcoidosis, but the disease may get better or even go away over time on its own. In some cases, treatment is needed and may include medication.

Post Covid-19 Syndrome

Post Covid-19 Syndrome occurs when the effects of Covid-19 lasts for more than four weeks after initial diagnosis. Those most likely to experience this are older individuals and people with serious medical conditions. However, it is not uncommon for younger and healthy people to feel the residual effects of Covid-19 for weeks or even months after infection. The most common symptoms that can linger include:

  • Fatigue
  • Shortness of breath or difficulty breathing
  • Cough
  • Fever
  • Chest pain
  • Sleep problems
  • Issues with memory or concentration
  • Muscle pain
  • Headache
  • Fast or pounding heartbeat
  • Loss of smell or taste
  • Depression or anxiety
  • Joint pain
  • Dizziness when standing
  • Worsened symptoms after physical or mental activities

More complex issues can also occur following a COVID infection including organ damage, blood clots, and blood vessel problems. It’s best to talk with your doctor if you are experiencing any prolonged symptoms.

Sleep Apnea

Sleep Apnea is a sleep disorder that occurs when a person briefly stops breathing repeatedly during sleep. If left untreated, sleep apnea can lead to serious medical conditions such as high blood pressure, stroke, heart failure, diabetes, and metabolic syndrome. Treatments can ease the symptoms of sleep apnea and may help prevent the development of more serious medical conditions.

Types of Sleep Apnea include:

  • Obstructive sleep apnea is the most common form and is caused by a complete or partial blockage in the upper airway as a result of muscles in the throat relaxing. Obesity, HTN, Smoking and Diabetes can put an individual at increased risk for developing this condition. The most common treatment for this form of sleep apnea is the use of a continuous positive airway pressure machine (CPAP) while sleeping. It is a mask generally worn over the nose and mouth that provides continuous adequate air pressure to ensure the upper airway passages remain open.
  • Central Sleep Apnea is not caused by a blockage but rather failure of the brain to send proper signals to the muscles that control breathing.
  • Complex sleep Apnea syndrome is a combination of both obstructive and central sleep apnea.

Symptoms of sleep apnea include:

  • Snoring
  • Excessive daytime fatigue
  • Waking with dry mouth
  • Gasping for air while sleeping
  • Headaches
  • Trouble concentrating during the day
  • Frequently waking up throughout the night
  • Irritability, depression, or anxiety

Learn about our Residency Program!

We are dedicated to growing the DPACC team.

DPACC | Dallas Pulminary & Critical Care

DPACC strives to provide better care for YOU.

Contact Us

1 (214) 960-5681