Complications arising out of Respiratory Disease

The respiratory system sustains life and is critical to the health and well-being of an individual.

Respiratory disease is a generic term that includes various infections, illnesses, diseases and disorders that affect the respiratory tract. The upper respiratory tract consists of the nose, the sinuses, the mouth (including the tonsils), the throat, the pharynx and the larynx or “voice box”. Ailments that affect these parts include the common cold, sore throat, tonsillitis, sinusitis and laryngitis. Complications arising out of them include discomfort in nose and throat, at times some difficulty in swallowing, change in voice, occasionally fever and rarely stridor (noisy inspiration).

For the sake of this article, we will focus on ailments that affect the lower respiratory tract. This consists of:

• Trachea or windpipe, which connects the throat to the lungs
• Bronchi which are the two branches that the trachea divides into as it enters the lungs
• Bronchioles which are the tiny airways that are found throughout the lungs
• Alveoli – tiny air sacs at the end of the bronchioles
• Pleura/pleurae which are the outer layer of the lungs that cover the lung tissues

There are various ailments that affect the above parts. Most common among them are:

Asthma

Asthma is a common and chronic respiratory condition which is characterised by inflammation of the airways. In this, the patient suffers from difficulty in breathing, shortness of breath, wheezing, chest tightness and dry cough. Allergic reactions, infections and pollution can all trigger an asthma attack.

Complications arising out of Asthma include:

• Pneumonia, a collapse of part or all of the lung and status asthmaticus which is a severe asthma attackthat does not respond to usual medication
• Respiratory failure caused when the oxygen level in the blood drops below safe levels, and carbon dioxide level in the blood exceeds safe levels

Pneumonia

Pneumonia is a common lung disease caused by an infection in the air sacs of the lungs, caused by bacteria, virus or fungus. While most people recover in one to three weeks, in some instances, pneumonia can be extremely serious and even life-threatening. Symptoms are cough, fever, shaking chills and shortness of breath, which can range from mild to severe.

Complications arising out of pneumonia include:

• Bacteremia and Septic Shock
• Lung Abscess
• Pleuritis, Pleural Effusion, and Empyema
• Acute respiratory distress syndrome or ARDS. with severe inflammation of the lungs
• Respiratory Failure

Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease is a generic term for various respiratory conditions that cause shortness of breath and difficulty in exhaling normally. Other symptoms include shortness of breath, and coughing up sputum (mucus from the lungs), especially in the morning. Heavy and long-term cigarette smoking is one of the common causes for COPD.

Complications arising out of COPD include:

Pneumonia, Acute respiratory distress syndrome or ARDS with severe inflammation of the lungs causes fluid to leak into the blood vessels of the airways, heart-failure, weight-loss, a decrease in muscle mass, fatigue and low physical activity.

Chronic Bronchitis

Chronic bronchitis is a form of COPD characterized by a chronic cough. Patients cough up sputum (mucus from the lungs), especially in the morning. It develops from a viral or bacterial infection.

Complications arising out of Chronic Bronchitis include:

Severe shortness of breath, respiratory failure and heart failure, and an increased mortality rate

Emphysema

Emphysema is a chronic respiratory disease and another form of COPD, generally caused by excessive smoking. Patients have trouble exhaling air from their lungs. Over time, this can lead to respiratory failure and the need for extra oxygen to meet breathing needs.

Complications arising out of Emphysema include:

• Pneumonia: People with emphysema are more prone to pneumonia
• Collapsed lung: In some lungs, large air pockets called bullae are formed, which may eventually burst, resulting in a condition called as pneumothoraxwhere there is air in the pleural space enveloping the lungs which then deflate
• Heart problems: damaged alveoli, reduced number of capillaries and lower oxygen levels in the blood stream require the heart to pump harder to move blood through the lungs. Over time, this putsenormous strain on the heart.

Lung Cancer

DNA mutations in the lungs cause irregular cells to multiply and create an uncontrolled growth of abnormal cells, or a tumour. These tumours interfere with the regular functions of the lungs. Risk factors include heavy cigarette smoking (active or passive smoking), workplace exposure to asbestos, diesel fumes, smoke, excessive dust, air pollution and radiation exposure from frequent CT scans of the chest.

Complications arising out of Lung Cancer include:

• Lung cancer can be complicated by occurrence of pleural effusion. In this, there is a build-up of fluid around the lungs. This can result in shortness of breath.Lung cancer scan also cause blockages in your major airways.
• Lung cancer can be associated with pneumonia
• Haemoptysis is bloody sputum, when the person coughs. This is due to bleeding in the airways
• Other complications include chest, back and bone pains which result from spread of the cancer to the bones
• If the lung cancer grows near the esophagus, you may have trouble swallowing when food passes through the esophagus on the way to the stomach.

Cystic Fibrosis/Bronchiectasis

In this condition, the patient has thick, sticky mucus clogging up his or her air-passages and air sacs. This is a genetic disease, or is caused by a defective gene. The mucus creates complications such as recurring and chronic lung infection. It can also cause malfunction of the pancreas which prevents important enzymes from breaking down nutrients required for the body.

It eventually leads to respiratory failure.

Pleural Effusion

Pleural effusion occurs when fluid accumulates between the lung and the chest wall in what’s called the pleural cavity. Causes for this include pneumonia, cancer or congestive heart failure. Symptoms include chest discomfort and shortness of breath.

Complications arising out of Pleural effusion include:

• Lung scarring,
• Collapse of the lung
• Empyema (a collection of pus within the pleural cavity)
• Sepsis (blood infection) sometimes leading to death

Tuberculosis

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis (MTB) bacteria, which generally affects the lungs, but can also affect other parts of the body. Common symptoms include fever, chills, night sweats, coughing out bloody sputum, appetite-loss, weight-loss and fatigue

Complications arising out of tuberculosis:

Pulmonary TB is associated with various long term lung complications such as fibrosis where there is scarring in the lungs, bronchiectasis, airway stenosis, COPDand CPA (Chronic Pulmonary Aspergillosis). TB is also known to be a risk factor for lung cancer.

Corona Viral Infections

Corona is a family of viruses which have caused various respiratory illness outbreaks since 2002. The latest episode of Covid-19 is also due to one of these viruses. Enough information has been provided in recent months about this infection; hence it will not be elaborated here.

Conclusion

Respiratory illnesses or diseases can be serious and sometimes fatal too. However, with increasing awareness, improved quality of medication and ongoing research, these illnesses have been tackled very effectively. For example, Tuberculosis was a dreaded disease once upon a time but is very effectively treated presently. Covid-19 may have brought respiratory diseases back into the limelight, but as one is aware, the number of deaths due to Covid-19 is steadily decreasing since July 2020 and a vaccine expected by end of 2020.

The key to overcoming respiratory illnesses lies in recognizing the symptoms and seeking medical help on time. Consult a super-speciality hospital which has expert pulmonologists on their rolls. These specialists will diagnose your ailment precisely and design a course for successful treatment and rehabilitation.

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Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

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