Managing COPD by Richard EK Russell

By Richard EK Russell

Managing COPD is an in-depth advisor at the administration of sufferers with COPD targeting the impression of COPD on a sufferer in addition to how healthcare execs can intrude and train the sufferer at an early degree and thereby sluggish the onset of serious signs. This ebook has been designed to extend general practitioner expertise of the pathological tactics serious about the aetiology of COPD which underpins powerful disorder management.

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Wheezing may occur during exacerbations and during periods of breathlessness. Ankle swelling may become noticeable when there is cor pulmonale. Weight loss often occurs in advanced disease, but the mechanism is at present uncertain: loss of skeletal muscle bulk may be a response to systemic inflammation. 12 COPD leads to a poor quality of life. 26 • manag i n g co p d Signs When FEV 1 is >50% of predicted, there may be no abnormal signs. The typical patient with more severe COPD shows a large, barrel-shaped chest owing to hyperinflation, diminished breath sounds, distant heart sounds owing to emphysema and prolonged expiration.

26 • manag i n g co p d Signs When FEV 1 is >50% of predicted, there may be no abnormal signs. The typical patient with more severe COPD shows a large, barrel-shaped chest owing to hyperinflation, diminished breath sounds, distant heart sounds owing to emphysema and prolonged expiration. Patients may also have generalised wheezing on expiration. Diagnosis Diagnosis is commonly made from a history of progressive shortness of breath in a chronic smoker and is confirmed by spirometry, which shows an FEV 1 /forced vital capacity (FVC) ratio of <70% and FEV 1 <80% of predicted.

Indeed the abdominal wall muscles may also be active. Breath sounds may be quiet and there may also be crackles present in the lungs. A wheeze is often heard and may lead to diagnostic confusion with asthma. It is essential to remember that many chest diseases may lead to an audible wheeze. Signs of cor pulmonale (right heart failure) must not be missed and should be specifically sought out. They include a raised jugular venous pulse, an enlarged heart with a loud second heart sound and perhaps even a right heart gallop rhythm.

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