COMMON RESPIRATORY CONDITIONS- PATIENT RESOURCES

It is well known that patients who understand their condition do better with therapy than those who do not understand their condition. Hence we have provided basic information about some common conditions here. 

COVID-19 *

COVID-19 is a new form of Coronavirus disease due to the novel virus SARS-CoV-2 that causes acute infection with respiratory symptoms. This new virus is different than the ones that cause SARS (Severe Acute Respiratory Syndrome) or MERS (Middle East Respiratory Syndrome). It is also different from the virus that causes seasonal influenza (flu). For more information, please go to American Thoracic Society web page Fact Sheets: A-Z

“ABNORMAL” CHEST X-RAY

Many of the above common respiratory conditions may be detected by an abnormal Chest X-ray that is done as part of routine screening. A common abnormality that is detected on screening Chest X-ray is the presence of lung nodule/s that is/are not causing any symptoms. Such radiographic detection may require expert opinion for work-up of the nature of the lung nodule/s. Not all such lung nodules are sinister although the abnormal Chest X-ray may turn out to be the first sign of malignancy in some cases.

The value of routine Chest X-ray screening is debatable and hence a CT scan is needed to further characterize the Chest X-ray abnormality in all cases. There is recent evidence to suggest that CT screening detects a number of lung cancers at an early potentially curable stage.

ASTHMA

A common respiratory disorder that afflicts many children and adults - proper treatment not only prevents unnecessary disruption of lifestyle but also reduces the deterioration of lung function that may lead to permanent breathlessness as one grows older.

Exercise is the most common trigger of bronchospasm (narrowing of the airways) in asthmatics and recent studies have found that asthma is the single greatest risk factor for unexplained death occurring among army recruits.

Furthermore, excessive narrowing of the airways (aka exercise-induced bronchoconstriction) may also occur in more than 10% of people without asthma. Hence exercise-induced bronchoconstriction (EIB) presenting as breathlessness, chest tightness or wheezing during exercise is a relatively common problem in athletes or people engaging in strenuous exercises.

Inability to perform up to one’s expected level of exercise requires careful evaluation, including exercise testing.

BREATHLESSNESS

It is NOT normal for a person to feel breathless or even to be aware of one’s breathing when one is at rest, i.e. not engaging in any strenuous activity. So if a person feels any difficulty breathing while at rest, it is an indication for a thorough check as this may be the earliest symptom of many serious disorders.

PNEUMONIA

This is an infection of the lungs. The microorganisms that can potentially cause this infection are numerous and the condition has gained recent recognition from COVID-19 virus, SARS (a severe pneumonia caused by a corona virus in 2003) and the Avian Flu. Appropriate and early treatment of any pneumonia is key to total eradication and complete recovery.

TUBERCULOSIS

An age-old lung condition that has never quite left us. Would you believe that one third of the world's population is infected with Tuberculosis (TB)? TB is still prevalent in Singapore and can affect young and old like. Like pneumonia, early detection is paramount to successful treatment. Complete eradication of TB is possible as we have effective medication against the TB bacilli.

LUNG CANCER

The commonest and deadliest type of cancer in many countries. It is the number 1 killer among all cancers. It is NOT caused by smoking only as thought of for several years. Thirty percent of lung cancer patients are never smokers. Early detection and treatment certainly helps in this form of cancer.

PNEUMOTHORAX- PLEURAL DISEASES (PROBLEMS WITH THE LINING AROUND THE LUNGS)

This is a condition in which air is collecting in the pleural cavity - the space within the chest, between the chest wall and the lung. Usually, this means that there is a leak in the lung that allows the air to escape from it and accumulate in the pleural cavity. The underlying lung may be reduced in size (lung collapse) as a result of the expanding pneumothorax. The treatment will depend on the size of the pneumothorax, the state of the underlying lung, as well as the number of times the condition has recurred.

PLEURAL EFFUSION

In this condition, instead of air, fluid has accumulated in the pleural cavity, causing gradual reduction of lung volume and breathlessness may result. Commonly known as 'fluid in the lungs', this is actually abnormal fluid surrounding the lungs within the chest or thorax. Because there is limited space within the thorax, the pleural effusion compresses the lung and hence patients with this condition may present with breathlessness and/or cough.

INTERSTITIAL LUNG DISEASE OR ILD  (PROBLEMS WITH THE TISSUES OF THE LUNGS)

This disease causes hardening of the lungs leading to cough, shortness of breath and disability. For more information, please go to American Thoracic Society web page Fact Sheets: A-Z

BRONCHOSCOPY

Flexible bronchoscopy is a visualization of the breathing passages of the lungs (called “airways or wind pipes”). It is like what endoscopy is for the stomach.It is done to get samples of mucus or tissue from the lungs.

RIGID BRONCHOSCOPY

Rigid Bronchoscopy is a procedure used to gain access to the patient's airway and allows the passage of larger airway instruments and cameras to diagnose and treat airway disease. This form of bronchoscopy is done by highly trained specialists. This is always done under general anesthesia. Airway is secure during the procedure and it allows for larger biopsies, tamponade (stop) bleeding areas, removal of airway tumor and foreign objects, and deploying airway stents to open up blocked airways.

CHRONIC COUGH

This is a very common problem – perhaps the commonest reason for people visiting their doctor. Any cough lasting longer than 8 weeks can be considered “chronic”. The possible causes are many, ranging from infections to airway problems. Medical consultation is necessary to illicit and treat the cause/s. Sometimes more than one cause of the cough may exist in a person. 

CHRONIC OBSTRUCTIVE PULMONARY DISEASE OR COPD, INCLUDES CHRONIC BRONCHITIS AND EMPHYSEMA

Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term that encompasses 2 main disorders--- emphysema and chronic bronchitis--diseases that are characterized by obstruction to air flow in and out of the lungs. Emphysema and chronic bronchitis frequently coexist. Thus physicians prefer the term COPD. COPD is a common cause of breathlessness and chronic cough among current or ex-smokers.

For more information on COPD, please visit the Chronic Obstructive Pulmonary Disease Association (Singapore) website   www.copdas.com  or American Thoracic Society.

 

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