Chronic Obstructive Pulmonary Disease
UT Southwestern Medical Center was recognized by U.S. News & World Report for 2018–19 as one of the nation’s best hospitals for the treatment of lung diseases and disorders.
Our dedicated pulmonologists are known for their expertise and excellence in diagnosing and managing COPD and other lung diseases. They offer people with COPD the latest treatments – including specialized pulmonary rehabilitation – to relieve their symptoms and help them maintain their health and well-being.
Advanced Care for Chronic Obstructive Pulmonary Disease (COPD)
Chronic obstructive pulmonary disease (COPD) is chronic, progressive lung disease that causes difficulty breathing. COPD develops when lung tissue is damaged or becomes inflamed as a result of inflammation in the walls of lung airways, excess mucus production in the airways, loss of elasticity in airways and air sacs of the lungs, or walls between air sacs break down.
If untreated, COPD can lead to life-threatening complications such as chronic respiratory failure and pulmonary hypertension (high blood pressure in the lungs). COPD is the third-leading cause of death in the United States.
UT Southwestern’s lung program is nationally recognized as a leader in patient care and research for COPD and other lung conditions. Our experienced team works closely with patients to determine the best course of treatment for each person. With years of expertise, we offer the most advanced health care options available for COPD, in a compassionate setting.
Types of COPD
The two most common types of COPD are:
- Emphysema: A lung condition in which the alveoli (air sacs) in the lungs weaken and rupture, reducing the amount of oxygen supplied to the body. Emphysema develops gradually, with many people affected for years before experiencing symptoms such as shortness of breath.
- Chronic bronchitis: A lung condition characterized by ongoing inflammation or irritation in the lining of the bronchial tubes. Chronic bronchitis is characterized by a daily cough that produces mucus (sputum) for at least three months per year for two consecutive years.
Smoke from tobacco or marijuana is the primary cause of COPD, but not everyone who smokes will develop the disease. Other risk factors for COPD include:
- Long-term exposure to (non-smoke) airborne irritants such as certain gases, fumes, or dust
- Frequent use of a cooking fire without proper ventilation
- Indoor biomass fuel exposure
Research has shown that a gene, pleomorphic adenoma gene-like 2 (PLAGL2), might be a contributing factor to emphysema and lung cancer development.
A rare type of emphysema results from an inherited, genetic defect (mutation) that prevents the body from making enough alpha-1 antitrypsin (AAT). AAT is a protein that protects the elastic structures in the lungs.
Symptoms of COPD
Because COPD develops slowly, doesn’t always cause symptoms in its early stages, and shares symptoms with many other conditions, people may not realize they have the condition until it is fairly advanced.
The main symptoms of COPD are chronic bronchitis and shortness of breath that develops gradually. Other common symptoms include:
- Lingering cough, either productive (with mucus) or non-productive (without mucus)
- Wheezing or whistling sound when breathing
- Chest tightness
- Shortness of breath, especially during exercise
- Frequent respiratory infections
- Swelling (edema) in legs, ankles, or feet
- Blue lips or nail beds (cyanosis)
- Unexplained weight loss
COPD is often misdiagnosed because its symptoms resemble those of other conditions. Our experienced lung specialists are skilled at evaluating symptoms to confirm COPD and rule out other conditions. We begin with a thorough evaluation that includes a:
- Physical exam
- Review of personal and family medical history
- Discussion of symptoms and any exposure to lung irritants
To confirm a diagnosis, we often recommend one or more additional tests, such as:
- Arterial blood gas measurement to check the levels of oxygen and carbon dioxide in the blood
- Blood tests to look for genetic causes
- Chest X-ray to produce images of the lungs to check for signs of disease and rule out other conditions
- Computed tomography (CT) scan to produce more detailed images of the chest to detect and diagnose emphysema using specialized X-ray technology that takes cross-sectional images
- Diffusion measurement to assess how well the lungs move oxygen into the bloodstream
- Lung volume measurement to determine how much air the lungs can process during inhaling and exhaling
- Spirometry assessment to measure the rate of air flow into and out of the lungs and estimate lung size
Treatment for COPD
UT Southwestern’s experienced lung specialists help COPD patients reduce their symptoms, live more comfortably, and slow or prevent the condition from progressing. Our team also advises patients on symptom-relieving lifestyle changes – such as quitting smoking, which is the best way to slow lung damage.
COPD treatment may include medications such as:
- Antibiotics to prevent and treat lung infections, such as acute bronchitis or pneumonia
- Bronchodilators (inhaled) to relieve cough, shortness of breath, and other problems by relaxing the muscles around the bronchial tubes
- Corticosteroids (inhaled) to reduce swelling in lung airways to improve shortness of breath
Nonsurgical COPD therapies may include oxygen therapy to increase blood oxygen levels and prevent high blood pressure in the lungs (pulmonary hypertension).
Pulmonary rehabilitation, which can improve lung function and overall health, is an essential nonsurgical therapy for COPD patients. UT Southwestern offers a long-term outpatient program with specialized therapists. Our services include:
- Instruction in breathing and coughing techniques
- Counseling and support
- Nutritional counseling
- Physical exercise recommendations
Surgery for COPD
People with severe lung damage caused by COPD may be candidates for surgeries that include:
- Lung volume reduction to remove small sections of damaged lung tissue, enabling remaining lung tissue to work better
- Lung transplant for people with advanced COPD for which other treatments have not worked
Over a recent 30-month period, our lung transplant program was rated the best in the nation for achieving the highest survival rate for one-year post-transplant patients. Since UT Southwestern’s lung transplant program began in 1990, it has consistently ranked among the top 10 in the United States.
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