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PULMONOLOGY

Pulmonology

Pulmonology is a field of medicine that is specifically concerned with the diagnosis and treating of disorders associated with the respiratory system. The respiratory system involves the organs that help us breathe and the three major parts of the respiratory system are the airway, the lungs, and the respiratory muscles. The airway includes the nose, mouth, pharynx, larynx, trachea, bronchi, bronchioles, and alveoli. Subspecialties of pulmonology include the following:

  • interstitial lung disease that focuses on lung diseases marked by persistent inflammation and scarring,
  • interventional pulmonology that employs multidisciplinary care for treating airway disorders, lung cancer, and pleural diseases,
  • lung transplantation and management before and after surgery,
  • the neuromuscular disease concerned with the conditions that occur due to respiratory muscle failure,
  • obstructive lung disease involving airway narrowing/obstruction, and
  • sleep-disordered breathing

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Conditions Treated in Pulmonology

Pulmonologists possess expertise in different types of respiratory disorders including infectious, structural, inflammatory, neoplastic which is associated with a tumor, and autoimmune. However, in some cases, this may extend to the cardiovascular system when certain conditions, such as pulmonary vascular disease, first affects the respiratory system that goes on to affect other organs in the body.

The conditions commonly treated in pulmonology include:

  • Asthma,
  • Bronchiectasis which is a condition involving inflammation and excess mucus,
  • Bronchitis that occurs when a person has inflamed lower airways,
  • Chronic Obstructive Pulmonary Disease(COPD) that causes airflow blockage,
  • Emphysema which occurs when the alveoli in the lungs are damaged,
  • Interstitial lung diseases that affect the space and tissues within the lung
  • Occupational lung diseases that occur due to the inhalation of dust, chemicals, or proteins,
  • Obstructive sleep apnea causing breathing to slow or stop entirely while sleeping

Diagnostic Tests in Pulmonology

  • Computed Tomography(CT): Computed Tomography Pulmonary Angiogram(CTPA) is a diagnostic test employing computed tomography angiography for obtaining detailed images of the pulmonary arteries, bones, muscles, fat organs, and blood vessels in the chest. Its main use is to diagnose pulmonary embolism and is a preferred choice of imaging for the diagnosis of pulmonary embolism. This is because it is minimally invasive in nature for the patient which only requires an intravenous line for the scan.
  • Pulmonary Function Test(PFT): Pulmonary Function Test(PFT) is a noninvasive test that shows how well the lungs are functioning. This test measures the lung volume, capacity, rates of flow, as well as gas exchange. This information helps the pulmonologist in diagnosing and deciding the treatment of certain lung disorders. PFT can be performed with two methods including Spirometry and Plethysmography. These two methods can be used together or performed individually based on the information that the pulmonologist is looking for.
  • Chest X-ray: Chest X-ray employs a very small dose of ionizing radiation to create images of the inside of the chest which is used to examine the lungs, heart, and chest wall. A chest X-ray produces pictures of the heart, lungs, airways, blood vessels, and the bones of the chest. It helps to diagnose the shortness of breath, persistent cough, fever, chest pain, or injury. It may also be used for diagnosing and monitoring treatment for a variety of lung conditions including pneumonia, emphysema, and cancer.

Treatment Procedures in Pulmonology

  • Pulmonary Rehabilitation: Pulmonary rehabilitation also referred to as respiratory rehabilitation, is an essential part of the management and health maintenance of those suffering from chronic respiratory diseases who remain symptomatic or continue to have reduced function despite medical treatment. Pulmonary rehabilitation is a broad therapeutic concept. In general, pulmonary rehabilitation refers to a series of services administered to patients of respiratory disease to improve the quality of life for the patient. It is carried out in a variety of settings based on the patient’s needs and may or may not involve pharmacologic intervention.
  • Bronchoscopy: Bronchoscopy is a medical procedure that allows the pulmonologist to view the lungs and air passages. During bronchoscopy, a thin tube called a bronchoscope having a light and a small camera is passed through the nose or mouth, down the throat, and into the lungs. Bronchoscopy may also be used to obtain samples of mucus or tissue, to remove foreign bodies or other blockages from the airways of lungs, or to provide treatment for lung problems.
  • Pulmonary Hypertension Treatment: Pulmonary hypertension is a condition where an increase in blood pressure occurs within the arteries of the lungs which includes symptoms like shortness of breath, syncope, tiredness, chest pain, swelling of the legs, and fast heartbeat. There is no cure for pulmonary hypertension but doctors may prescribe certain treatments to improve the symptoms and slow down the progress of pulmonary hypertension that include:
    • Vasodilators: Vasodilators relax and open narrowed blood vessels to improve the blood flow. One of the most commonly used vasodilators for pulmonary hypertension is epoprostenol. This drug continuously flows through an intravenous line attached to a small pump which is worn in a pack on the belt or shoulder. Other types of vasodilators include treprostinil that can be inhaled, injected, or taken orally.
    • Oxygen Therapy: The doctor might sometimes suggest patients breathe pure oxygen that helps to treat pulmonary hypertension, especially when they live at a high altitude or have sleep apnea. Some people with pulmonary hypertension eventually need continuous oxygen therapy.
    • Atrial septostomy: Atrial septostomy is a surgical procedure where a small hole is created between the upper left and right chambers of the heart. This procedure is primarily used to palliate the Dextro-transposition of the great arteries which is a life-threatening cyanotic congenital heart defect found in infants. It is done before the arterial switch operation. The two types of atrial septostomy procedures include balloon atrial septostomy, also called endovascular atrial septostomy, and blade atrial septostomy, also called static balloon atrial septostomy.

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