One of the most common pathologies that cause permanent inflammation of the respiratory system is chronic obstructive pulmonary disease (COPD for short). Although the term itself began to be used relatively recently, the number of patients with this disease is quite impressive (approximately 5-10% of the population). Such disappointing statistics is primarily due to the huge mass of smokers - they constitute the overwhelming number of patients.

Since the disease is often detected already in the last stages, mortality within 10 years after visiting a doctor is 55% of all recorded cases. In addition, its complications often lead to loss of performance and disability. Therefore, it is imperative that a timely diagnosis and treatment of COPD be initiated.

COPD is a disease in its own right. It is characterized by a restriction of air passage through the respiratory tract, and in some cases this process is irreversible. This pathological condition is caused by inflammation of the lung tissue, in turn due to a nonspecific response of the patient's body to some pathogenic microparticles or gases.

COPD diagnosis is a collective term that includes:

• chronic obstructive bronchitis (including purulent);
• pneumosclerosis;
• pulmonary hypertension;
• emphysema resulting from a violation of the patency of the bronchial tree;
• chronic cor pulmonale.

All of these diseases reflect structural changes and dysfunction of key body systems that occur at different stages of COPD. Some have signs of several pathological conditions at once.

Causes

In most cases, chronic obstructive pulmonary disease develops in people over 40. The majority of patients are men. This selective effect is based on the specific etiology of the disease. There are the following reasons for its occurrence:

• Smoking. It is the main culprit in COPD (more than 80% of patients), and this is typical mainly for developed countries, since there the percentage of smokers is higher. They have shortness of breath and respiratory tract obstruction much faster. A fairly high percentage of the risk of getting sick also exists among those who are regularly exposed to secondhand smoke. This is especially harmful for children.
• Professional factors... These include some areas of the industry, the by-product of which is the release of micro-dust particles with a high content of silicon and cadmium into the air. These are the mining and metallurgical industries, the cellulose industry, as well as work directly related to the production and use of cement.
• Hereditary pathologies... The genetic causes of the development of chronic obstructive pulmonary disease are still under study, but it is already reliably known that one of them is the lack of α1-antitrypsin. It controls the activity of elastase, which is involved in the breakdown of various protein structures. If the production of this protein body is reduced by more than 30%, elastase begins to destroy the lung tissue, causing emphysema.

There are several other factors that are believed to lead to this disease. These include underweight, air pollution, familial illness, and regular inhalation of biofuel combustion products during cooking (observed in people living in underdeveloped countries).

Prematurity and frequent acute respiratory infections in children can also lead to the development of the disease, although there is no statistics on the frequency of cases at this age. At the same time, COPD is recorded in adolescents as a consequence of bronchial asthma (according to some sources, the frequency is 4-10%).

Of course, the above risk factors, when present in isolation, are unlikely to cause chronic obstructive pulmonary disease. But since in the modern world with a developed industry, high air pollution and other consequences of human life, they act together with improper diet and bad habits. Therefore, the number of diseases is growing every year, and the life expectancy of patients due to untimely detection in the general percentage decreases.

Development mechanism

The pathogenesis of the disease originates from the bronchial walls. Under the influence of external factors, the functioning of the exocrine apparatus is disrupted, which leads to increased secretion of mucus and a change in its composition. After a while, an infection occurs, which causes an inflammatory process that takes on a permanent form.

Since chronic obstructive pulmonary disease is progressive, the pathogenic microflora gradually destroys the tissues of the bronchi, bronchioles and adjoining alveoli. This course of the disease leads to a decrease in the supply of oxygen to the body, which, in turn, has an extremely negative effect on the work of all its systems. In this case, the heart experiences the greatest stress, as a result of which the functioning of the respiratory organs is greatly impaired.

Classification

The formulation of the diagnosis is largely based on the severity of the disease. For this, the reduction in the flow rate of the inhaled air is determined and, on the basis of the data obtained, the so-called Tiffeneau index is calculated - an indicator of a possible decrease in the throughput of the patient's respiratory tract.

A special device is used for measurements - a spirometer. It will help you find out two main values ​​on the basis of which COPD is classified: forced expiratory volume (FEV) and forced vital capacity (FVC). Their percentage is the Tiffno index.

In addition, it is necessary to take into account the symptomatic manifestations and the frequency of exacerbations of the disease. In modern medicine, there are 4 degrees of severity of chronic obstructive pulmonary disease:

• It proceeds easily, manifests itself as a periodic wet cough. Shortness of breath in most cases is not observed. FEV / FVC<70% от исходного значения. ОФВ>80% of the norm.

• Moderate course of the disease with noticeable shortness of breath on exertion and persistent cough. Obstruction increases, possibly exacerbation of COPD. FEV / FVC<70%, ОФВ<80% от должного.

• The disease is characterized by severe symptoms. The patient has a constant wet cough, wheezing in the sternum, the slightest physical exertion causes severe shortness of breath. Periods of exacerbation occur regularly. FEV / FVC<70%, ОФВ<50% от исходного значения.

• The condition is extremely serious, in some cases even life-threatening. Obstruction of the bronchi is pronounced,. At this stage, destructive processes in the body lead to disability. FEV / FVC<70%, ОФВ<80% от нормы.

Starting from stage 3, COPD can be divided into two types, depending on the clinical manifestations:

• Bronchodilator... Here, cough is the predominant symptom. At the same time, it is pronounced. Since cor pulmonale develops early, the skin becomes cyanotic over time. The concentration of erythrocytes in the blood, as well as its total volume, is constantly increased, which often leads to the formation of blood clots, hemorrhages, and heart attack.
• Emphysematous. This type includes COPD with prevailing dyspnea. Patients are characterized by intense breathing that exceeds the need for oxygen. Patients often complain of weakness, depression, and weight loss. There is a strong depletion of the body.

Symptoms

Chronic obstructive pulmonary disease does not appear immediately. Usually, noticeable signs are observed only 3-10 years after its onset. But even in this situation, the patient does not always go to the doctor. This behavior is especially typical for smokers. They consider coughing to be quite normal, since they inhale nicotine smoke every day. Of course, they determine the reason correctly, but they are mistaken with their further actions.

Most often, the disease is recorded in people aged 40-45 years, when the patient already feels significant shortness of breath. Therefore, it is important to know the main symptoms of COPD, especially in the initial stages:

• Cough . Of all the signs, it arises in the first place, having an episodic character. Then it becomes daily. In the absence of an exacerbation, sputum usually does not come out.
• Sputum. Appears some time after the development of a periodic cough into a permanent one. Initially observed mainly in the morning. If the sputum becomes purulent, this indicates the development of an exacerbation.
• Dyspnea. This symptom means the transition of the disease to stage 2. Usually it is of the mixed type, less often - only with difficulty in exhaling. In the initial stages, it manifests itself only with strong physical stress, intensifying during acute respiratory infections. As the patient progresses, shortness of breath increases, limiting the patient's activity. In severe pathology, it develops into respiratory failure.

• If you work in a production facility and have started coughing from industrial dust, then most likely you are developing.
• There is such a disease in children -. This is a hereditary pathology. We advise you to familiarize yourself.
• Rapid breathing is a clear sign. This problem, like others, can be treated with folk remedies and medicines.

Exacerbation of COPD

If the patient's condition constantly worsens for 2 or more days, this phase is called an exacerbation. In this case, the main symptoms of the disease intensify, an increased temperature is observed. Depending on the severity of the pathology, the frequency of repetition of such periods can vary widely. The intervals between them are called remission phases. The exacerbation of the disease has its own characteristics of the course:

• significant increase in shortness of breath and cough;
• an increase in the volume of sputum secreted;
• frequent shallow breathing;
• high temperature;
• tachycardia;
• various neurological pathologies (for example, unmotivated excitement or depression).

Complications

At various stages of the disease, many destructive changes occur in the body, most often irreversible. Therefore, in the overwhelming majority of cases, patients have the following syndromes:

• Bronchial obstruction... It develops from the first stages of chronic obstructive pulmonary disease and gradually progresses. This process usually begins in the small bronchi. This results in increased resistance in the lower airways. Due to the deformation of the alveoli, the lung tissue loses its elasticity, and pulmonary fibrosis is formed.
• Pulmonary hypertension... The main complications of COPD affect the cardiovascular system. Hypertension is provoked by a narrowing of the circulatory system in the respiratory organs, aggravated by a thickening of the walls of blood vessels. This increases the level of pressure required for blood to flow through the network of capillaries that feed the lung.
• Pulmonary heart e. For what reasons in some patients there is an increase in the right ventricle, is still not fully known.
• Lung hyperinflation... At the same time, the lungs overflow with air and are not completely emptied when exhaling. This gradually weakens the breathing muscles, changing the shape of the diaphragm. This state is especially felt during physical exertion, not allowing to increase the depth of breathing.
• Emphysema Since the connection of the small bronchi with the alveoli is disrupted, this negatively affects their patency.
• General intoxication of the body... In some patients, muscle weakness develops, and an inflammatory reaction syndrome is often present. All this leads to a decrease in physical activity, a general deterioration in well-being.

Diagnostics

For a correct diagnosis, it is initially necessary to determine whether a person is exposed to risk factors for developing chronic obstructive pulmonary disease. If the patient smokes, the level of possible danger caused by this habit should be calculated at all times. This will help the so-called smoker's index, calculated by the formula: (number of daily smoked cigarettes * total experience (years)) / 20. If the resulting number is more than 10, the danger of getting sick is very real. Diagnosis of COPD includes the following steps:

• Clinical and biochemical blood test... It is recommended to do it 2 times a year, as well as during periods of exacerbation.
• Sputum analysis. Determination of its macro- and microscopic properties. If necessary, conduct a study for bacteriology.
• Electrocardiogram... Since chronic obstructive pulmonary disease often causes complications in the heart, it is advisable to repeat this procedure 2 times a year.
• X-ray of the sternum. You need to do it annually (this is at least).
• Spirometry. It allows you to determine how severe the condition of the pathologies of the respiratory system is. It is necessary to pass once a year and more often in order to adjust the course of treatment in time.
• Blood gas and pH analysis... Do at 3 and 4 degrees.
• Oxyhemometry. Evaluation of the degree of blood oxygen saturation by a non-invasive method. It is used in the exacerbation phase.
• Monitoring the ratio of fluid to salt in the body... The presence of a pathological shortage of certain microelements is determined. It is important in exacerbation.
• Differential diagnosis... Most often diff. diagnosed with lung cancer. In some cases, it is also required to exclude heart failure, tuberculosis, pneumonia.

The differential diagnosis of bronchial asthma and COPD is especially noteworthy. Although these are two separate diseases, they often occur in the same person (the so-called overlap syndrome). The reasons and mechanisms of this are not fully understood, therefore, it is necessary to know the differences in their clinical manifestations. So, starting from grade 2, patients experience shortness of breath. After the attachment of bronchial asthma, it intensifies, and as the pathologies progress, asthma attacks become more frequent. This is a rather dangerous condition that can be fatal.

A full range of laboratory tests and a thorough study of the patient's history will allow to give the correct formulation of the diagnosis of the disease. This includes the degree and severity of COPD, the presence of an exacerbation, the type of clinical presentation and complications that have occurred.

Chronic obstructive disease treatment

It is still impossible to completely cure chronic obstructive pulmonary disease with the help of drugs of modern medicine. Its main function is to improve the quality of life of patients and prevent severe complications of the disease.

COPD can be treated at home. The exceptions are the following cases:

• home therapy does not give any visible results or the patient's condition worsens;
• respiratory failure intensifies, developing into an attack of suffocation, heart rhythm is disturbed;
• 3 and 4 degrees in the elderly;
• complications in severe form.

In remission

To expand the bronchi, a complex of inhalations of bronchodilators is made (check the dosage with your doctor):

• M-cholinolytics: "Ipratropium bromide" ("Atrovent"), 0.4-0.6 mg or "Thiopropium bromide" ("Spiriva"), 1 capsule - effectively block M-cholinergic receptors in parasympathetic nerve endings;
• "Fenoterol" or "Salbutamol" 0.5-1 ml - drugs with pronounced bronchodilator activity.

Since the accumulation of mucus in the respiratory tract contributes to the addition of infections, mucolytic drugs are used to prevent these diseases:

• "Bromhexin", "Ambroxol" - reduce the secretory function of the respiratory system and change the composition of mucus, weakening its internal connections;
• "Trypsin", "Chymotrypsin" - medications of a protein nature, actively interacting with the accumulated secretion, reducing its viscosity and eventually leading to destruction.

With exacerbation

Treatment of chronic obstructive pulmonary disease in the acute phase involves taking glucocorticoids, more often it is "Prednisolone". With severe respiratory failure, the drug is administered intravenously. Since systemic medicines of this group have many side effects, now in some cases they are replaced with drugs that inhibit the functions of pro-inflammatory mediators ("Fenspirid", "Erespal"). If treatment with these medicines at home does not show positive results, the patient must be hospitalized.

In addition, in this phase, emphysema often progresses and mucus stagnation is formed. These conditions can lead to the development of complications, namely bronchitis or pneumonia. To prevent this from happening, antibacterial therapy is prescribed to prevent these diseases - penicillins, cephalosporins, fluoroquinolones.

In the elderly

For the elderly, an individual approach is required, since, due to some peculiarities, the course of the disease is most often severe. There are a number of factors to consider before treating them:

• age-related changes in the respiratory system;
• the presence of additional diseases associated with COPD, and their mutual influence;
• the need to take many medications;
• difficulties in diagnosis and adherence to the course of treatment;
• psychosocial features.

Nutrition

To maintain the body in the tone necessary to resist the disease, a balanced diet is necessary:

• the use of a sufficient amount of proteins (slightly more than the norm) - meat and fish dishes, dairy products;
• with a reduced body weight, high-calorie nutrition is needed;
• multivitamin complexes;
• reduced salt content in case of complications (pulmonary hypertension, bronchial asthma, and others).

Prophylaxis

COPD treatment will not show positive dynamics until the patient has eliminated all the factors that provoke this disease. The main recommendations are smoking cessation and timely prevention of infections affecting the respiratory system.

Effective prevention of COPD includes learning all the information about the disease, as well as knowing how to use the medical devices required during treatment. The patient should know how to properly inhale, measure the highest rate of air exit from the lungs using a peak flow meter. And, of course, it is necessary to follow all the recommendations of the doctors.

COPD is a slowly progressive disease that can worsen and even die over time. Therapy can only slow down these processes, and the adequacy of its application directly depends on how much more the patient will remain working. In some cases, periods of remission last up to several years, so such patients live for decades.

Smoking is the leading cause of COPD, and most people with the condition either still smoke or have smoked in the past. Long-term exposure to other lung irritants, such as air pollution, chemical fumes, or dust, can also contribute to the development of COPD.

What is chronic obstructive pulmonary disease (COPD)

The air that you breathe enters down through the windpipe into a branch of the windpipe called the bronchi.

In the lungs, your bronchi branch out into thousands of small, thin tubes called bronchioles. These tubes end in clusters of tiny, round air sacs called alveoli.

Small blood vessels called capillaries pass through the walls of the alveoli. When air reaches the alveoli, oxygen flows through their walls into the blood in the capillaries. At the same time, carbon dioxide (carbon dioxide) moves from the capillaries to the alveoli. This process is called gas exchange.

The airways and alveoli are elastic, and when you inhale, each alveoli fills with air like a small balloon, and when you exhale, the alveoli shrink.

In chronic obstructive pulmonary disease, less air enters the lungs and, accordingly, less air leaves them. This happens for one or more of these reasons:

• The airways and alveoli lose elasticity.
• The walls between many alveoli collapse.
• The walls of the airways are swollen and inflamed.
• The airways produce more mucus than normal, which can clog them.

The term COPD includes two main diseases - emphysema and chronic bronchitis. In emphysema, the walls between many of the alveoli are damaged or even destroyed. As a result, the alveoli lose their shape, which leads to the formation of fewer shapeless large alveoli instead of many small ones. If this happens, then gas exchange in the lungs deteriorates.

In chronic bronchitis, the mucous membrane of the respiratory tract is constantly irritated and inflamed. This leads to swelling of the mucous membrane and narrowing of the airways. During chronic bronchitis, thick mucus is present in the respiratory system, which also makes breathing difficult.

Most people with COPD also have emphysema and chronic bronchitis. Thus, the general term "COPD" is more accurate.

Forecast

COPD is one of the leading causes of disability and is the third leading cause of death in developed countries. Currently, chronic obstructive pulmonary disease has been diagnosed in millions of people. And many more people may have this disease without even knowing it.

COPD develops slowly. Symptoms often get worse over time and can limit your ability to engage in daily activities. Severe COPD can almost completely incapacitate you, becoming an obstacle to even basic activities such as walking, cooking, or taking care of yourself.

Most cases of COPD are diagnosed in middle-aged or elderly people. The disease is not spread from person to person, so you cannot catch it from someone else.

COPD is currently not cured because doctors do not know how to reverse damage to the airways and lungs. However, existing treatments and lifestyle changes can help you feel better, stay more active, and slow the progression of the disease.

Causes of COPD

Long-term exposure to irritants that damage the lungs and airways is usually the cause of COPD.

The most common irritant causing COPD is tobacco smoke. Tobacco smoke from smoking pipes, cigars, cigarettes, etc. can also cause chronic obstructive pulmonary disease, especially if the smoke is inhaled directly into the lungs.

Secondhand smoke, air pollution, chemical fumes, or dust from the environment or workplace can also contribute to the development of COPD. (Secondhand smoke is inhaling tobacco smoke when other people smoke near you.)

In rare cases, a genetic disorder called alpha-1-antitrypsin deficiency may play a role in COPD. People with this condition have low levels of alpha-1-antitrypsin (AAT), a protein synthesized in the liver.

If a person has low AAT protein levels, it can damage the lungs and develop COPD if you are exposed to smoke or other lung irritants. If you have this condition and smoke, COPD can get worse very quickly.

Although rare, some people with asthma can develop COPD. Asthma is a chronic lung disease in which the airways become inflamed and swollen. Treatment can usually reverse inflammation and reduce swelling. However, if asthma is left untreated, COPD can develop.

Who is at risk of developing COPD

Smoking is the main risk factor for developing COPD. Most people with COPD currently smoke or have smoked in the past. People with a family history of chronic obstructive pulmonary disease (COPD) are usually more likely to develop COPD if they smoke.

Long-term exposure to other lung irritants is also a risk factor for developing COPD. These irritants include:

• second hand smoke
• air pollution
• chemical fumes
• dust in the environment
• house dust

People in their 40s or older usually begin to develop symptoms of chronic obstructive pulmonary disease. Rarely enough, people under the age of 40 can develop COPD. This can happen if the person is deficient in alpha-1-antitrypsin (an inherited disorder).

What are the signs and symptoms of COPD

First, COPD may cause no symptoms or only mild symptoms. As the disease progresses, symptoms usually become more severe. Common signs and symptoms of chronic obstructive pulmonary disease are:

• Persistent cough or cough that produces a lot of mucus (often called "smoker's bronchitis").
• Difficulty breathing, especially during physical activity.
• Shortness of breath (wheezing or wheezing when breathing).
• Oppression in the chest.

If you have COPD, you may also have frequent colds or flu.

Not every person who has the above symptoms has COPD. In addition, not every person with COPD experiences these symptoms. Some of the symptoms of chronic obstructive pulmonary disease are similar to those of other diseases and conditions. For an accurate diagnosis, you need to see your doctor.

If your symptoms are mild, you may not even notice them, or you may make some lifestyle changes to make breathing easier. For example, you can use the elevator instead of the stairs.

Over time, COPD symptoms can become severe enough to require medical attention. For example, you may develop shortness of breath during physical activity.

The severity of your symptoms will depend on how badly your lungs are damaged. If you continue to smoke, your lung tissue will be destroyed faster than if you quit smoking.

Severe COPD can cause other symptoms such as swelling in the ankles, feet, or legs, weight loss, and decreased muscle endurance.

Some severe symptoms may require hospital treatment. You or your loved ones (if you are not able to do it yourself) should seek emergency medical attention if:

• Breathing is very difficult (you are out of breath and have difficulty speaking).
• Your lips or nails turn blue or gray. (This is a sign of low blood oxygen levels.)
• Your brain functions have worsened (disturbances in thinking, poor thinking).
• Your heart rate is very fast.
• The recommended treatment for symptoms that are getting worse does not work.

COPD diagnosis

Your doctor will diagnose COPD based on your symptoms, your medical and family history, and test results and diagnostic procedures.

Your doctor may ask if you smoke or if you are in contact with lung irritants such as tobacco smoke (secondhand smoke), air pollution, chemical fumes, or dust.

If you have a chronic cough, you need to tell your doctor about it (how long have you been suffering from persistent coughing, how much mucus is coughing up when you cough). In addition, if your family has had a history of COPD, you should also tell your doctor about it.

The doctor will examine you and listen to your lungs with a stethoscope to check your breathing for wheezing or other unusual sounds in your chest. He may also recommend one or more diagnostic procedures to diagnose COPD.

Pulmonary function tests

A lung function test measures how much air you can breathe in and out, how quickly you can breathe out, and how well your lungs deliver oxygen to your blood.

The main diagnostic procedure for diagnosing COPD is spirometry. Other lung function tests, such as a lung diffusion test, can also be used.

Spirometry

During this painless procedure, your doctor will ask you to take a deep breath. Then, you will blow as hard as you can into the tube attached to the small appliance. This device is called a spirometer.

This device measures the amount of air you breathe out. It also measures the maximum expiratory flow rate.

Your doctor may give you a medication to help open your airways and then ask you to blow again. He can then compare the test results before and after taking the medication.

Spirometry can detect COPD before symptoms appear. Your doctor may also use the test results to find out how severe your COPD is and help set treatment goals.

Diagnostic results can also help identify other medical conditions, such as asthma or heart failure, as these may also be the cause of your symptoms.

Other diagnostic procedures

• Chest X-ray (Computed Tomography or CT). CT diagnostics take pictures of the internal organs of the chest, such as the heart, lungs, and blood vessels. Images may show signs of COPD. They can also show another medical condition, such as heart failure, which may also be causing your symptoms.
• Arterial blood gas analysis. This blood test measures the oxygen level in the blood using a blood sample taken from an artery. The results of this test can show how serious your COPD is and whether you need oxygen therapy.

COPD treatment

Chronic obstructive pulmonary disease cannot be cured. However, lifestyle changes and treatments can help you feel better, stay more active, and slow the progression of the disease.

COPD treatment goals:

• Easing your symptoms.
• Slowing the progression of the disease.
• Making you feel better with exercise (increasing your ability to stay active).
• Prevention and treatment of complications.
• Improving overall health.

In order to start treatment for your condition, you need to see a pulmonologist (a doctor who specializes in diseases of the respiratory tract).

Lifestyle changes

Quit smoking and avoid exposure to lung irritants

Quitting smoking is the most important step you can take to treat COPD. Talk with your doctor about programs and remedies that can help you quit smoking.

Also, try to avoid secondhand smoke, stay away from smoking areas, dusty places, and avoid inhaling chemical fumes or other toxic substances that you may inhale.

Other lifestyle changes

If you have chronic obstructive pulmonary disease (COPD), you may have trouble eating enough food due to symptoms such as shortness of breath and fatigue. (This problem is more common in severe cases.)

As a result, you cannot get the calories and nutrients you need, which can worsen your condition and increase your risk of infections.

Talk to your doctor about a nutritional plan that suits your body's needs. Your doctor may suggest eating less, but more often; rest before eating; and take vitamins or nutritional supplements.

Also, talk with your doctor about which activities are safe for you. You may find it difficult to be active with COPD symptoms. However, physical activity can strengthen muscles that help you breathe and improve your overall health.

Medication

Bronchodilators (bronchodilators)

Bronchodilators relax the muscles in the airway. This helps open the airways and makes breathing easier.

Depending on the severity of your COPD symptoms, your doctor may prescribe short-acting or long-acting bronchodilators. Short-acting bronchodilators are drugs that last about 4-6 hours and should only be used when needed. Long-acting bronchodilators work for about 12 hours or more and are used daily.

Most bronchodilators are taken with a device called an inhaler. This device allows the medication to flow directly into the lungs. Not all inhalers are used in the same way. Ask your doctor to show you the correct way to use the inhaler.

If your COPD symptoms are mild, your doctor may only prescribe short-acting bronchodilators. In this case, you can only use the medication when symptoms appear.

If you have moderate to severe COPD, your doctor may prescribe regular use of short-acting and long-acting bronchodilators.

Combination of bronchodilators with inhaled glucocorticosteroids (ICS)

If your COPD symptoms are more severe, or if your symptoms occur frequently, your doctor may prescribe a combination of medications such as bronchodilators and inhaled steroids. Steroids help reduce airway inflammation.

In general, the use of inhaled steroids alone is not the preferred treatment.

Your doctor may recommend that you try using inhaled steroids with bronchodilators for 6 weeks to 3 months to see if adding a steroid helps relieve your breathing problems.

Vaccines

Flu shot

The flu can cause serious problems for people with COPD. Flu shots can reduce the risk of getting the flu (not proven to be life-threatening). Talk with your doctor about the annual flu vaccine.

Vaccination against pneumococcal infection

This vaccine reduces the risk of developing pneumococcal pneumonia and its complications. People with COPD are at a higher risk of developing pneumonia than people without COPD. Talk to your doctor about whether you should get this vaccine.

Pulmonary rehabilitation

A pulmonary rehabilitation (recovery) program helps improve the condition of people with chronic breathing problems.

Rehabilitation may include an exercise program, training in disease control, nutritional counseling, and psychological support. The goal of the program is to help you stay active and carry out your daily activities.

Doctors, nurses, physiotherapists, pulmonologists, rehabilitation therapists and nutritionists will help you with this. These healthcare professionals will help you create a program that meets your needs.

Oxygen therapy

If you have severe COPD and low blood oxygen levels, oxygen therapy can help you breathe better. With this type of treatment, oxygen is supplied to your lungs through nasal cannulas or an oxygen mask.

You may need supplemental oxygen all the time or only at certain times. For some people with severe COPD, using oxygen therapy for most of the day can help with the following:

• Perform tasks or activities while experiencing fewer symptoms.
• Protect your heart and other organs from damage.
• Sleep more during the night and improve alertness during the day.
• Live longer.

Oxygen therapy for chronic obstructive pulmonary disease

Surgery

Surgery may benefit some people with COPD. Surgery is usually the last resort for people experiencing severe symptoms that do not improve with medication.

People with chronic obstructive pulmonary disease (COPD), which is mainly associated with emphysema, usually have bullectomy or lung volume reduction surgery. A lung transplant may be an option for people with very severe COPD.

Bullectomy

When the walls of the alveoli collapse, large air spaces called bullae begin to form in the lungs. These air spaces can become so large that they interfere with breathing. During a bullectomy, doctors remove one or more very large bullae from the lungs.

Lung volume reduction surgery

During Lung Volume Reduction (LVR) surgery, surgeons remove damaged tissue from the lungs. This helps the lungs to function better. This surgery is only performed on some people with COPD, and if done successfully, it can help improve a person's breathing and quality of life.

Lung transplant

During a lung transplant, your damaged lung is removed and replaced with a healthy lung from a deceased donor.

A lung transplant can improve your lung function and quality of life. However, there are many risks associated with lung transplantation, such as infections. The operation can be fatal if the body rejects the transplanted lungs.

If you have very serious COPD, talk to your doctor about whether a lung transplant is necessary for you. Ask your doctor about the benefits and risks of this type of surgery.

Complications of COPD

COPD symptoms usually get worse over time. However, they can also get worse suddenly. For example, a cold, flu, or a lung infection can make you feel worse quickly, which can make it very difficult for you to breathe. You may also have increased chest tightness and coughing, a change in the color or amount of phlegm coming from your lungs, and a rise in body temperature.

Call your doctor right away if your symptoms suddenly get worse. To help you breathe, he may prescribe antibiotics to treat the infection, as well as other medications such as bronchodilators and inhaled steroids. Some severe symptoms may require hospitalization.

Prevention of COPD

There are some steps you can take to prevent COPD even before it starts. If you are already suffering from this condition, you can take steps to prevent complications and slow the progression of the disease.

Preventing COPD Before Onset

If you do not smoke, never try to start smoking, as smoking is the main cause of chronic obstructive pulmonary disease. If you already smoke, you need to get rid of this bad habit completely. If you smoke and want to quit but can't do it yourself, talk to your doctor about programs and remedies that can help you quit smoking.

Also, try to avoid inhaling harmful substances that irritate the lungs, as exposure to them can contribute to the development of COPD. Secondhand smoke, air pollution, chemical fumes and dust can all contribute to the development of this disease.

Preventing complications and slowing the progression of COPD

If you already have the first signs of COPD, the most important step you can take is to quit smoking completely. This can help you prevent complications from developing and slow the progression of the disease. You should also avoid exposure to the lung irritants mentioned above.

Follow the treatment regimen for COPD that your doctor has prepared for you. It can help you breathe easier, stay more active, avoid developing severe symptoms, and keep them under control.

Talk to your doctor about whether you should get flu and pneumonia shots. These vaccines can reduce the risk of these diseases (insufficient evidence - vaccines can be life-threatening), which are major health risks for people with COPD.

Living with COPD

Chronic obstructive pulmonary disease is currently not treated. However, you can take steps to control your symptoms and slow the progression of the disease. You need:

• Get ongoing care
• Keep your disease and its symptoms under control
• Prepare for emergencies

Avoid lung irritants

If you smoke, you need to quit smoking. Smoking is the leading cause of COPD. Talk with your doctor about programs and remedies that can help you quit smoking.

Also, try to avoid inhaling substances that irritate the lungs, as these can contribute to the development of COPD. The main lung irritants are:

• second hand smoke
• air pollution
• chemical fumes

Try to keep these irritants out of your home. If your home is painted or has been killing insects with insect sprays, you should be out of the house for as long as possible.

If the air is very polluted and dusty, keep windows closed and stay at home (if possible).

Get ongoing care

If you are suffering from chronic obstructive pulmonary disease, it is very important to receive ongoing medical attention. Take all the medicines your doctor has prescribed for you. Bring a list of all your medications to your regular check-ups.

Talk to your doctor about whether you should get the flu and pneumonia vaccine. Also, ask him about other conditions that may increase the risk of COPD. These can include heart disease, lung cancer, and pneumonia.

Controlling COPD Symptoms

There are several things you can do to control your COPD symptoms. For example:

• Do physical activities slowly.
• Place items you frequently use in one place so that they are easy to reach.
• Find very easy ways to cook, clean, and do other household chores.
• Wear clothes and shoes that are easy to put on and take off.

Depending on how serious your illness is, you may want to ask your family and friends for help with daily tasks.

Preparing for emergencies

If you have COPD, you need to know when and where to seek help in an emergency. You should seek emergency medical attention if you have severe symptoms such as shortness of breath or inability to speak normally.

Call your doctor if you notice that your symptoms are getting worse or if you have signs of an infection such as a fever. Your doctor may change or adjust treatments to relieve and treat the symptoms of chronic obstructive pulmonary disease.

Keep the phone numbers of your doctor, hospital, or someone else who can provide medical assistance to you handy. You should also have a referral to your doctor and a list of all medications you are taking on hand.

COPD, the symptoms of which significantly impair the quality and duration of life of patients, is a serious pathology of the human respiratory system. At the heart of the disease is a partial restriction of air supply to the respiratory tract of a person. The changes are irreversible and tend to progress.

Development of chronic obstructive pulmonary disease

The main reason for the development of pathology in adults is nicotine addiction. The disease can occur against the background:

1. Industrial hazards (constant inhalation of gases). Obstructive pulmonary disease is a standard disease for miners, agricultural workers, railway workers. The disease occurs during prolonged work with silicon, cotton, grain, elements of the pulp and paper and metallurgical industries.
2. Frequent and prolonged respiratory distress during childhood.
3. Environmental pollution. Dirt and exhaust gases increase the production of viscous mucus, disrupting the airway.
4. Genetic predisposition. The symptom is the lack of alpha-1-antitrypsin, which is responsible for protecting the mucous membrane of the lungs from negative environmental influences. Its insufficiency is fraught with the susceptibility of the lungs to all kinds of pathologies.

Over time, COPD irreversibly changes the airways: peribronchial fibrosis develops, emphysema is possible. Failure of breathing increases, bacterial complications are added. Against the background of obstruction, gas exchange is disturbed (O2 decreases, CO2 increases in arterial blood), cor pulmonale occurs (the cause of poor blood circulation, mortality of patients).

Stages of pulmonary obstruction

Experts distinguish 4 stages of COPD. The distribution by stages was based on a decrease in the ratio of FEV1 (forced expiratory volume in the first second) to FVC (forced vital capacity of the lungs) - the so-called Tiffno test. The pathology is evidenced by a decrease in this indicator of less than 70% against the background of taking bronchodilating drugs. Each stage of COPD is characterized by certain symptoms:

1. Stage 0 - pre-painful condition. This is a period of increased risk of developing pathology. It starts with a cough, which transforms into a constant cough, while the secretion of sputum increases. Lung function does not change. Timely treatment at this stage prevents further development of the disease.
2. Stage 1 - mild COPD. Chronic cough and sputum production remain, minor obstructive disorders appear (FEV1 is more than 80%).
3. Stage 2 - moderate pathology. Obstructive disorders increase significantly (FEV1 is less than 80%, but more than 50%). Shortness of breath, palpitations, weakness, dizziness develop.
4. Stage 3 - a severe form of pathology. Significant obstructive disorders (FEV1 less than 50%, but more than 30%). Shortness of breath and exacerbations worsen. These symptoms are observed even at rest.
5. Stage 4 is a very severe form of COPD. An extreme degree of bronchial obstruction, which is life-threatening (FEV1 less than 30%) of the patient. Signs of significant respiratory failure are observed, pulmonary heart disease may appear.

Clinical forms of the disease

COPD symptoms develop in stage 2 of the disease. Deciphering the disease in the early stages is almost impossible, since it often proceeds secretly. The main symptoms: cough with phlegm, shortness of breath. At first, the cough is episodic, the sputum is mucous. Shortness of breath appears against the background of strong physical exertion. Then the cough becomes constant, the amount of sputum increases (it becomes viscous, purulent). Shortness of breath worries patients constantly.

The addition of an infection is fraught with aggravation of the patient's condition: the body temperature rises, the amount of sputum increases, and a wet cough appears. Obstruction can develop in two clinical forms:

1. Bronchitic type. Symptoms are associated with purulent inflammation of the bronchi. The patient has the following symptoms: significant intoxication, cough, profuse purulent sputum. In the first place - significant bronchial obstruction, and pulmonary emphysema is poorly expressed. Symptoms and treatment of the disease depend on the age of the patient. The bronchitic type of COPD can lead to serious complications. At the terminal stage of obstruction, patients have “blue edema”.
2. With the development of the emphysematous type of COPD, patients complain of dyspnea of ​​an expiratory nature (difficulty in exhaling). The emphysematous changes in the lungs come to the fore, and not obstructive manifestations. Patients acquire a pinkish-gray skin color, cachectic exhaustion is observed. When diagnosing, the doctor notes a barrel-shaped chest, therefore, patients with this diagnosis are called "pink puffers". This form of the disease is much more favorable than the previous one. It has a slow progression. She has a good prognosis.

COPD can be complicated by:

• pneumonia;
• respiratory failure (acute and chronic);
• erythrocytosis (secondary polycythemia);
• congestive heart failure;
• pulmonary hypertension and cor pulmonale.

Diagnostic methods

Pathology slowly but surely progresses, damaging the human respiratory tract. This requires a timely and accurate diagnosis of the body. To diagnose COPD, your doctor will:

1. Taking anamnesis with the obligatory clarification of the presence of bad habits and occupational risk factors.
2. Spirometry is the gold standard for COPD diagnosis. Evaluate speed and volume indicators. Among them: vital capacity of the lungs (VC), forced vital capacity of the lungs (FVC), forced expiratory volume in 1 second (FEV1). The indicators are analyzed before and after taking bronchodilators to assess the degree of obstruction reversibility.
3. Sputum cytology. This study is carried out in order to clarify the nature, severity of bronchial inflammation, to exclude oncopathology. Viscous, purulent sputum with a large number of bronchial epithelial cells and leukocytes indicates an exacerbation of pathology, and the presence of a large number of mucous macrophages indicates remission of the obstruction.
4. Clinical and biochemical blood tests. Deciphering a blood test for obstruction indicates polycythemia (an increase in all blood cells), and increased viscosity is the result of the development of oxygen deficiency. To confirm hypoxemia, the gas composition of the blood is studied.
5. X-ray examination. It is carried out for differential diagnosis with other pathologies, but with a similar clinic. With COPD, radiographs show seals, deformations of the walls of the bronchi, changes in the lungs of an emphysematous nature.
6. ECG. Reveal hypertrophic changes in the right heart, possible blockade of the legs of His, an increase in the T wave.
7. Bronchoscopy. It is carried out for the differential diagnosis of pathology. The doctor examines and assesses the condition of the mucous membrane in an adult patient, takes the secretion of the bronchi for analysis. By bronchoscopy, you can inject the drug into the lesion.

The goal of a comprehensive and methodical examination of a patient is to make a correct and timely diagnosis.

This will slow down the development of respiratory failure, reduce the frequency of exacerbations, and significantly improve the duration and quality of life.

Video about the diagnosis and treatment of COPD:

Forecast and prevention

The prognosis of the pathology is unfavorable. With the progression of the obstruction, the patient's performance decreases, and disability may occur. To reduce the frequency and severity of exacerbations, it is recommended:

• eliminate the provoking factor;
• strictly follow all the doctor's recommendations;
• saturate the body with vitamins, minerals and healthy food.

Videos about symptoms and treatment of COPD:

To prevent the development of obstructive pathologies, it is necessary to quit smoking, comply with labor protection rules in production, timely treat respiratory pathologies, and prevent exacerbations of COPD.

Pulmonary obstruction is a progressive disease of the bronchopulmonary system in which the air in the airways does not flow properly. It is associated with abnormal inflammation of the lung tissue in response to external stimuli.

This is a non-infectious disease, it is not associated with the vital activity of pneumococci. The disease is widespread, according to WHO, in the world, 600 million people suffer from obstruction of the lungs. Mortality statistics show that 3 million people die from the disease every year. With the development of megacities, this figure is constantly growing. Scientists believe that mortality will double in 15-20 years.

The problem of the prevalence and incurability of the disease is the lack of early diagnosis. A person does not attach importance to the first signs of obstruction - cough in the morning and shortness of breath, which appears faster than peers when performing the same physical activity. Therefore, patients seek medical help at the stage when it is already impossible to stop the pathological destructive process.

Risk factors and mechanism of disease development

Who is at risk of pulmonary obstruction and what are the risk factors for the disease? Smoking comes first. Nicotine several times increases the likelihood of obstruction of the lungs.

Occupational risk factors play an important role in the development of the disease. Occupations in which a person is constantly in contact with industrial dust (ore, cement, chemicals):

• miners;
• builders;
• workers in the pulp processing industry;
• railway workers;
• metallurgists;
• workers for the processing of grain, cotton.

Atmospheric particles that can serve as a trigger for the development of the disease are exhaust gases, industrial emissions, industrial waste.

Also, a hereditary predisposition plays a role in the occurrence of pulmonary obstruction. Internal risk factors include hypersensitivity of the tissues of the respiratory tract, lung growth.

The lungs produce special enzymes - protease and antiprotease. They regulate the physiological balance of metabolic processes, maintain the tone of the respiratory system. When there is a systematic and prolonged exposure to air pollutants (harmful air particles), this balance is disturbed.

As a result, the frame function of the lungs is impaired. This means that the alveoli (lung cells) collapse and lose their anatomical structure. Numerous bullae (vesicle formations) form in the lungs. So the number of alveoli gradually decreases and the rate of gas exchange in the organ decreases. People begin to feel severe shortness of breath.

Inflammation in the lungs is a reaction to pathogenic aerosol particles and progressive airflow restriction.

Stages of development of pulmonary obstruction:

• tissue inflammation;
• pathology of small bronchi;
• destruction of the parenchyma (lung tissue);
• limiting the air flow rate.

Lung obstruction symptoms

Obstructive airway disease is characterized by three main symptoms: shortness of breath, cough, sputum production.

The first symptoms of the disease are associated with respiratory failure.... The person is short of air. It is difficult for him to climb several floors. The trip to the store takes more time, the person constantly stops to catch his breath. It becomes problematic to leave the house.

Development system of progressive dyspnea:

• initial signs of shortness of breath;
• shortness of breath with moderate physical activity;
• gradual limitation of loads;
• significant reduction in physical activity;
• shortness of breath when walking slowly;
• refusal from physical activity;
• constant shortness of breath.

Patients with pulmonary obstruction develop a chronic cough. It is associated with partial obstruction of the bronchi. The cough is persistent, daily, or intermittent, with rises and falls. Typically, the symptom worsens in the morning and may appear during the day. At night, coughing does not bother a person.

Shortness of breath is progressive and persistent (daily) and only gets worse over time. It is also exacerbated by physical activity and respiratory illness.

With obstruction of the lungs, sputum discharge is recorded in patients. Depending on the stage and neglect of the disease, mucus can be scanty, transparent or abundant, purulent.

The disease leads to chronic respiratory failure - the inability of the pulmonary system to provide high-quality gas exchange. Saturation (oxygen saturation of arterial blood) does not exceed 88%, with a norm of 95-100%. This is a life-threatening condition. In the last stages of the disease, a person may experience apnea at night - choking, stopping pulmonary ventilation for more than 10 seconds, on average, it lasts half a minute. In extremely severe cases, respiratory arrest lasts 2-3 minutes.

In the daytime, a person feels severe fatigue, drowsiness, instability of the heart.

Obstruction of the lungs leads to early disability and a reduction in life expectancy, a person acquires a disability status.

Obstructive pulmonary changes in children

Pulmonary obstruction in children develops as a result of respiratory diseases, malformations of the pulmonary system, chronic pathologies of the respiratory system... The hereditary factor is of no small importance. The risk of developing pathology increases in a family where parents constantly smoke.

Obstruction in children is fundamentally different from obstruction in adults. Blockage and destruction of the airways are the result of one of the nosological forms (a certain independent disease):

1. Chronical bronchitis. The child has a wet cough, rales of various sizes, exacerbations up to 3 times a year. The disease is a consequence of the inflammatory process in the lungs. The initial obstruction is due to excess mucus and phlegm.
2. Bronchial asthma. Despite the fact that bronchial asthma and chronic pulmonary obstruction are different diseases, in children they are interrelated. Asthmatics are at risk of developing obstruction.
3. Bronchopulmonary dysplasia. This is a chronic pathology in babies in the first two years of life. The risk group includes premature and low birth weight babies who have had ARVI immediately after birth. In such infants, the bronchioles and alveoli are affected, and the functionality of the lungs is impaired. Respiratory failure and oxygen dependence gradually appear. Gross tissue changes (fibrosis, cysts) occur, bronchi are deformed.
4. Interstitial lung disease. It is a chronic hypersensitivity of lung tissue to allergenic agents. Developed by inhalation of organic dust. It is expressed by diffuse damage to the parenchyma and alveoli. Symptoms - cough, wheezing, shortness of breath, impaired ventilation.
5. Obliterating bronchiolitis. This is a disease of the small bronchi, which is characterized by narrowing or complete blockage of the bronchioles. Such obstruction in a child mainly manifests itself in the first year of life.... The reason is ARVI, adenovirus infection. Signs are unproductive, heavy, recurrent cough, shortness of breath, weak breathing.

Diagnosis of pulmonary obstruction

When a person visits a doctor, an anamnesis is collected (subjective data). Differential symptoms and markers of pulmonary obstruction:

• chronic weakness, decreased quality of life;
• unstable breathing during sleep, loud snoring;
• increase in body weight;
• an increase in the circumference of the collar zone (neck);
• blood pressure is above normal;
• pulmonary hypertension (increased pulmonary vascular resistance).

The compulsory examination includes a general blood test to exclude a tumor, purulent bronchitis, pneumonia, anemia.

A general urine analysis helps to exclude purulent bronchitis, in which amyloidosis is detected - a violation of protein metabolism.

A general sputum test is rarely done, as it is uninformative.

Patients undergo peak flowmetry, a functional diagnostic method that evaluates the expiratory flow rate. This is how the degree of airway obstruction is determined.

All patients undergo spirometry - a functional study of external respiration. The rate and volume of breathing are assessed. Diagnostics is carried out on a special device - a spirometer.

During the examination, it is important to exclude bronchial asthma, tuberculosis, bronchiolitis obliterans, bronchiectasis.

Treatment of the disease

The goals of treatment for pulmonary obstruction are multifaceted and include the following steps:

• improved respiratory function of the lungs;
• constant monitoring of the manifestation of symptoms;
• increasing resistance to physical stress;
• prevention and treatment of exacerbations and complications;
• stopping the progression of the disease;
• minimization of side effects of therapy;
• improving the quality of life;

The only way to stop the rapid destruction of the lungs is to quit smoking altogether.

In medical practice, special programs have been developed to combat nicotine addiction in smokers. If a person smokes more than 10 cigarettes a day, then he is shown a drug course of therapy - short up to 3 months, long - up to a year.

Nicotine replacement treatment is contraindicated in the following internal pathologies:

• severe arrhythmia, angina pectoris, myocardial infarction;
• circulatory disorders in the brain, stroke;
• ulcers and erosion of the digestive tract.

Patients are prescribed bronchodilatory therapy. Basic treatment includes bronchodilators to dilate the airways... The drugs are prescribed both intravenously and by inhalation. When inhaled, the drug instantly penetrates into the affected lung, has a quick effect, and reduces the risk of negative consequences and side effects.

During inhalation, you need to breathe calmly, the duration of the procedure is on average 20 minutes. With deep breaths, there is a risk of severe coughing and choking.

Effective bronchodilators:

• methylxanthines - Theophylline, Caffeine;
• anticholinergics - Atrovent, Berodual, Spiriva;
• b2-agonists - Fenoterol, Salbutamol, Formoterol.

In order to improve survival, patients with respiratory failure are prescribed oxygen therapy (at least 15 hours a day).

To liquefy mucus, enhance its discharge from the walls of the respiratory tract and expand the bronchi, a complex of drugs is prescribed:

• Guaifenesin;
• Bromhexine;
• Salbutamol.

To consolidate the treatment, obstructive pneumonia requires rehabilitation measures. Every day, the patient must carry out physical training, increase strength and endurance. Recommended sports are walking for 10 to 45 minutes daily, exercise bike, lifting dumbbells. Nutrition plays an important role. It should be rational, high in calories, and high in protein. An integral part of the rehabilitation of patients is psychotherapy.

Every experienced pulmonologist knows what the complications of COPD are. Chronic obstructive pulmonary disease is a chronic, constantly progressive disease of various etiologies, which is characterized by impaired lung function and the development of respiratory failure.

This pathology begins to develop at a young age. In the absence of rational treatment, the disease leads to formidable complications, which often become the cause of premature death.

What are the consequences of COPD

Chronic obstructive pulmonary disease is very common. This pathology develops mainly against the background of prolonged smoking, inhalation of dust, as well as in the presence of occupational hazards.

COPD is manifested by a wet cough, expiratory dyspnea, and cyanosis of the skin. The consequences for the patient can be very serious.

This disease can lead to the following complications:

• pneumonia;
• respiratory failure;
• increased blood pressure in the pulmonary circulation (pulmonary hypertension);
• pulmonary heart;
• chronic and acute heart failure;
• spontaneous pneumothorax;
• blockage of large vessels by a thrombus;
• atrial fibrillation;
• pneumosclerosis;
• secondary form of polycythemia;
• bronchiectasis.

The emergence of complications of COPD is most often due to non-compliance with doctor's prescriptions or inability to quit smoking.

Why COPD is dangerous for the lungs

Pulmonary complications of COPD include pneumosclerosis. This is a condition in which normal tissue is replaced by connective tissue. This leads to impaired gas exchange and the development of respiratory failure. A prolonged inflammatory process leads to the proliferation of connective tissue and deformation of the bronchi.

Pneumosclerosis is preceded by pulmonary fibrosis. The greatest danger to humans is pneumocirrhosis.

This is an extreme degree of sclerosis. It is characterized by compaction of pleural tissues, replacement of alveoli with connective tissue and displacement of the mediastinal organs.

Pneumosclerosis is focal and diffuse (total). Often, both lungs are involved in the process at once. Total pneumosclerosis against the background of COPD is manifested by the following symptoms:

• shortness of breath on exertion and at rest;
• bluish skin tone;
• obsessive cough with sputum production.

Chest pain may appear. With cirrhosis of the lung, the chest is deformed. Displacement of large vessels and heart occurs. Pneumosclerosis can be detected by radiography. Another dangerous complication of COPD is spontaneous pneumothorax. This is a condition in which air from the lung enters the pleural cavity. Pneumothorax is an urgent need.

In males, this pathology develops more often. After a few hours, an inflammatory reaction occurs. Pleurisy develops. With pneumothorax, one lung collapses. With the development of bleeding, hemothorax is possible (accumulation of blood in the pleural cavity). Pneumothorax develops rapidly. Such people develop sharp or pressing chest pain on one side and severe shortness of breath. The pain increases with inhalation and coughing. In severe cases, the patient may lose consciousness. With pneumothorax, the pulse increases and a feeling of fear appears.

Development of respiratory failure

Against the background of COPD, respiratory failure almost always develops. In this condition, the lungs cannot maintain the required blood gas composition. This is not an independent disease, but a pathological syndrome.

A distinction is made between acute and chronic respiratory failure. The first is characterized by hemodynamic disturbances. It develops in minutes or hours. Chronic lung failure is less violent.

It develops over weeks or months. There are 3 degrees of this pathological condition. In case of lung insufficiency of 1 degree, shortness of breath, which occurs after significant physical exertion, is worried. At grade 2, mild physical exertion can cause shortness of breath. At grade 3, difficulty breathing is observed at rest. At the same time, the oxygen content in the blood decreases.

Heart disease associated with COPD

COPD can cause heart failure. This lung disease leads to increased pressure in the pulmonary circulation, which contributes to the development of cor pulmonale. With it, there is a thickening of the organ wall and expansion of the right sections, since it is from the right ventricle that a small (pulmonary) circle of blood circulation begins.

This condition occurs in acute, subacute and chronic forms. In acute cor pulmonale with COPD, the following symptoms are observed:

• severe shortness of breath;
• pain in the region of the heart;
• pressure drop;
• cyanosis of the skin;
• swelling of the veins in the neck;
• increased heart rate.

Collapse sometimes develops. The liver is often enlarged. With subacute cor pulmonale, the pain is moderate. Patients are worried about hemoptysis, shortness of breath and tachycardia.

In the chronic form of the disease, the symptoms are mild. At the same time, shortness of breath increases gradually. Nitrates do not relieve pain. In the later stages, edema appears. A decrease in urine output is possible.

Neurological symptoms appear (headache, dizziness, weakness, drowsiness). The most dangerous for a person is heart failure in the stage of decompensation. With her, there are signs of dysfunction of the right ventricle. Stagnation of blood in a small circle against the background of COPD contributes to the development of heart failure.

This is a condition in which the contractile function of the myocardium is impaired. It can be acute and chronic. A pronounced violation of contractility of the heart causes a deterioration in gas metabolism, edema, tachycardia, oliguria, decreased performance, sleep disorders. In severe cases, exhaustion develops.

There are 3 stages of chronic respiratory failure. The first is characterized by shortness of breath and palpitations on exertion. In a state of rest, a person feels satisfactory. At stage 2, symptoms appear at rest.

The development of ascites and the appearance of edema are possible. Stage 3 is characterized by dysfunction and morphological changes in organs (kidneys, liver).

Other dangerous conditions

COPD can lead to complications such as erythrocytosis. This is a condition in which there is an increased production of red blood cells and a high content of hemoglobin in the blood. Erythrocytosis in this situation is secondary. This is the body's response to developing respiratory failure. A large number of red blood cells increases the oxygen capacity of the blood.

Erythrocytosis (polycythemia) can go unnoticed for a long time. The following symptoms are most often observed:

• noise in ears;
• headache;
• dizziness;
• chilliness of the arms and legs;
• sleep disturbance;
• the appearance of spider veins on the skin;
• redness of the sclera and skin;
• itchy skin;
• hyperemia of the fingertips.

Another complication of COPD is pneumonia. Its development is due to a violation of mucociliary clearance and sputum stagnation, which leads to the activation of microbes. A link has been established between pneumonia and the use of inhaled glucocorticoids for the treatment of COPD. Most often, pneumonia is detected in people with diabetes mellitus and other concomitant diseases.

Secondary pneumonia associated with COPD has a high mortality rate. Inflammation of the lungs in such patients often occurs with severe shortness of breath, pleural effusion and renal failure. Septic shock sometimes develops.

Another complication of COPD is the formation of bronchiectasis.

This is a pathological expansion of the bronchi.

The process involves both large bronchi and bronchioles. Both lungs can be affected at once. Most often, the extensions are determined in the lower lobes. Their appearance is associated with the destruction of the walls of the bronchi. Bronchiectasis is manifested by hemoptysis, chest pain, irritability, cough with foul-smelling phlegm, cyanosis or pallor of the skin, weight loss, and thickening of the phalanges of the fingers.

This video talks about chronic obstructive pulmonary disease:

Thus, COPD is a dangerous and intractable disease. To prevent the development of complications, you need to visit a doctor and adhere to his recommendations. Self-medication can lead to irreversible consequences.