1. What every physician needs to know:
Chronic obstructive pulmonary disease (COPD) refers to all lung diseases characterized by a decrease in expiratory airflow that is not completely reversible.
The term is usually employed in describing increased resistance to airflow in the small airways caused by excessive inflammation following chronic exposure to noxious inhaled substances. In contrast, asthma, although also a disease characterized by chronic obstruction to airflow, entails reversible airway inflammation that occurs in response to environmental antigens.
In COPD, the obstruction is expiratory in nature since airway resistance is greatest during the end of expiration, when the small airway lumen has the smallest diameter and offers the greatest resistance. This issue is important with regard to both symptoms and management outcome.
Although COPD exists in those who have never smoked and does occur in patients under age forty-five, the overwhelming majority of cases arise in the fifth and sixth decades of life and are related to chronic cigarette smoke exposure. Dust exposure results in a similar risk of developing COPD to that of exposure to biomass fuel smoke or cigarette smoke.
Although rare, genetic causes, specifically, alpha-1 anti-trypsin (A1AT) deficiency,should be ruled out in newly diagnosed COPD, as specific intervention may be offered for this disorder.
Reposted with permission from Decision Support in Medicine, LLC.