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Lung Disease: Conditions
Lung Conditions
Abnormal Chest Imaging
We routinely encounter pulmonary infiltrates and infections, pulmonary nodules or masses, other pulmonary parenchymal abnormalities, and pleural fluid collections. Often a multidisciplinary approach is required for diagnosis and treatment, and we foster close relationships with other departments.
Abnormal Pulmonary Function
Evaluation of an abnormal pulmonary function test or low oxygen level noted on routine medical evaluation. The cornerstone of pulmonary diagnostics is the pulmonary function test. Interpretation of these tests is approached carefully, and the test is often repeated if initial results are inconsistent.
Abnormal Pulmonary Pressures
Evaluation of abnormal blood pressure in the pulmonary arteries, routinely identified on echocardiography. This could indicate the presence of a serious pulmonary vascular disease and may result in referral to our Pulmonary Hypertension Program.
Acute and Chronic Lung Infections
This refers to common pneumonia, atypical pneumonia, mycobacterial infections, and conditions that predispose patients to recurrent infections, such as cystic fibrosis and bronchiectasis. Recommendations for antimicrobial therapy and pulmonary hygiene therapy are made based on the most up-to-date research being conducted worldwide. Occasionally patients are referred and co-managed by an Infectious Disease specialist, or to the Cystic Fibrosis Program. Immune therapies are recommended when deficiencies are identified.
Acute and Chronic Respiratory Failure
This refers to a loss of pulmonary function resulting in the need for supplemental oxygen and/or other support as indicated. All clinics are equipped to determine appropriate oxygen requirements and the need for additional support such as BIPAP or chronic mechanical ventilation.
Allergies
Allergies are reactions caused by the body's immune system as it responds to substances in the environment. They may occur in response to different allergens like food, pollen, dust mites, animals, insect stings, or medication.
Allergies can affect different parts of the body like the eyes, nose, or skin.
Other conditions like asthma, which affects the lungs, is closely related to allergies but have slightly different underlying cause.
Alpha 1 Antitrypsin Deficiency
A genetic disease that results in the early development of emphysema, especially when the patient uses smokable tobacco products. Emory U. Hospital at Midtown is an officially designated clinical resource center by the Alpha 1 Foundation. Alpha 1 patients with end-stage emphysema often meet the criteria for lung transplantation, referral to the McKelvey Lung Transplant Program may be an option.
Asthma
Asthma is a chronic disease that affects your airways. Your airways are tubes that carry air to your lungs. If you have asthma, your airways' walls become sore and swollen, making them very sensitive. They may be reacting strongly to allergies. When your airways react, they get tighter, and your lungs get less air.
Asthma symptoms include:
- Wheezing
- Coughing, especially early in the morning or at night
- Chest tightness
- Shortness of breath
Not all people who have asthma have these symptoms, and symptoms don't always mean that you have asthma. Your doctor will diagnose asthma based on lung function tests, your medical history, and a physical exam.
When your asthma symptoms become worse than usual, it's called an asthma attack. Severe asthma attacks may require emergency care, and they can be fatal.
Asthma cases that are particularly difficult to manage will be referred to the Asthma and Allergy Clinic.
Chronic Obstructive Pulmonary Disease (COPD)
An obstructive lung disease that typically results from smoking. The condition is not reversible but often responds well to treatment. Patients present with wheezing, coughing, shortness of breath, respiratory failure, and frequent lung infections. The condition is managed based on current guidelines, with the application of newer therapies when appropriate.
Cystic Fibrosis
Cystic fibrosis is the most common life-shortening genetic disease among Caucasians in the United States. While substantial improvements in quality and length of life for cystic fibrosis patients have been achieved over the past four decades, the median survival age remains less than half of that for the general population. Therefore, aggressive care, new therapies, and new therapeutic targets are still in need of identification. Our team actively contributes to the health and well-being of patients with cystic fibrosis by establishing the highest standards of clinical care.
Interstitial Lung Disease (ILD)
Interstitial Lung Disease (ILD) describes many disorders, most of which cause progressive lung tissue scarring. The scarring connected with interstitial lung disease ultimately affects a person's ability to breathe and get adequate oxygen into the bloodstream.
Interstitial lung disease may be caused by long-term exposure to hazardous materials, such as asbestos. Some autoimmune diseases, such as rheumatoid arthritis, can also cause interstitial lung disease. In some situations, however, the causes remain unknown.
Once scarring occurs, it is generally irreversible. Medications may slow the damage of ILD, but many people never regain full use of their lungs.
A confirmed ILD diagnosis would mean referral to our ILD Program for possible biopsy and multidisciplinary characterization and management.
Lung Cancers
Diagnosis and treatment of small cell and non-small cell carcinomas, bronchoalveolar cell carcinoma, and other lung malignancies. A cancer diagnosis is best managed with a multidisciplinary approach, which would mean referral to Winship Cancer Center and/or Surgical referral as well.
Lung Transplantation
Transplantation is an option for patients who have progressive respiratory decline despite optimal therapy for their lung disease. Patients are often referred early in the evolution of their disease process if they are expected to decline. The best candidates for transplant are those who are relatively healthy otherwise, with decent functional capacity and strong social support. Common indications for lung transplantation include advanced COPD, cystic fibrosis, alpha 1 antitrypsin deficiency, pulmonary fibrosis, and pulmonary hypertension (see McKelvey Lung Transplant Program).
Nose and Sinus Disorders
Chronic sinusitis affects over 30 million people in the U.S. It occurs when the spaces in the nose and head (sinuses) become inflamed and swollen.
This interferes with mucus drainage and creates a stuffy nose.
Chronic sinusitis may be brought on by an infection, growths in the sinuses (nasal polyps), or inflammation of the lining of your sinuses. Also called chronic rhinosinusitis, the condition can affect both adults and children.
Occupational Lung Disease
Diagnosis, treatment, and identification of the offending materials can be challenging and may require a multidisciplinary approach. Examples include diseases related to asbestos exposure (mesothelioma and malignancies), coal, silica, and talc exposure (pneumoconiosis), work-related asthma, and hypersensitivity pneumonitis. A careful history is essential to these diagnoses.
Preemptive Pulmonary Evaluations
Pulmonary evaluation is often required in anticipation of major surgery, prior to initiation of therapies associated with significant pulmonary side effects, or before employment in certain occupations. Reports with full recommendations are provided to the referring physician in these cases.
Pulmonary Hypertension
Pulmonary hypertension is high blood pressure in the heart-to-lung system that delivers fresh blood to the heart while returning used blood to the lungs.
Unlike systemic blood pressure (the force of your blood moving through the blood vessels in your body), pulmonary blood pressure reflects the pressure the heart exerts to pump blood from the heart through the lungs' arteries. In other words, it focuses on the pressure of the blood flow in your lungs.
Sleep Disorders
Obstructive sleep apnea and all other sleep-related disorders are seen frequently. Difficult-to-manage cases are referred to the Sleep Center.
Symptoms
Acute or chronic cough, shortness of breath, wheezing, chest pain, hemoptysis (coughing blood), and fevers are a few of the many symptoms encountered in our clinics. These symptoms may be present alone or in association with an existing condition such as connective tissue disease, occupational or environmental exposures, or a history of cigarette smoking. Often patients present to our clinic with a diagnosis that does not adequately explain their symptoms. Exhaustive efforts to arrive at an accurate diagnosis and appropriate management plan are the norm at The Emory Clinic.
Venous Thromboembolism
Diagnosis and management of DVT and PE, with recommendations for anti-clotting and other therapies based on the most current guidelines. Patients with the chronic thromboembolic disease are referred to the Pulmonary Hypertension Program.