Information on this page is NOT meant to address the symptoms you may be experiencing at present. If you are trying to diagnose the cause of a symptom you are experiencing right now, please STOP reading this page and call your medical provider or call 911 as you see fit for your condition. Information provided on this patient is general in nature and does not apply to an individual.
Shortness of breath: We normally go on about our lives without ever being aware of our breathing. When we start becoming aware of our breathing, it is usually because our brain is making us aware that something is not right with our breathing so that we can address it. It may be subtle and you may still be able to go about your life with this subtle awareness or it may be severe enough that you may have to call 911. Even if it is subtle, it is probably best to address it with a medical professional. Some of the common causes of shortness of breath are Asthma, COPD, blood clots to the lungs, Congestive Heart Failure, Anemia, lung infection. Please read these documents from American Thoracic Society Breathlessness and Breathlessness – Sudden for more information.
Cough: When you cough, it is most likely due to something irritating your airway or lungs. By coughing you are trying to get whatever caused the irritation out of your body. It is normal to cough once in a while. By coughing you expel whatever is causing the irritation and you are done with the cough. But if you cough repeatedly, it may be a sign that you are not able to expel whatever is irritating your airways or lungs. In such circumstances, it may be worth seeking medical advice to diagnose the cause of irritation and provide appropriate treatment. Some common causes of cough are smoking, Asthma, Bronchitis, COPD, Post Nasal drip, Acid reflux, lung infections, some medications such as ACE inhibitors, lung cancer. Please visit National Institute of Health’s Cough page for more information.
Wheezing: Normally, breathing, which is essentially moving air in and out of the lungs does not produce any audible sound. However, if there is an obstruction anywhere along in the airway, it can produce sound as the air passes through the narrow portion of the airway. When the obstruction is at the level of small airways, the sound is usually produced during breathing out. It is called wheezing and is usually seen in Asthma and COPD.
Coughing up blood: Coughing up blood is NOT normal. If you are coughing up blood, you MUST seek medical advice for further evaluation and management.
Lung nodule: Lung nodule or lung mass or spots on lung are abnormalities usually picked up on a CXR and Chest CT scan. They do not always indicate cancer but because they could potentially be cancer, such findings should be evaluated to find out their cause. If you have been told of having a lung nodule or lung mass, you should talk to your physician about further investigations appropriate in your case. Please read this Lung Nodule Document from American Thoracic Society for more information.
Cigarette Smoking: If you have COPD and you smoke, you will get most benefit by quitting smoking than you will from any medication to treat COPD. Medicines for treatment of COPD are effective in helping you breath better but they are NOT powerful enough to counter the harmful effects for ongoing smoking. Your breathing is unlikely to improve much even if you take your COPD medicines but continue to damage your lungs by smoking. Even if you currently do not have lung disease and smoke, you MUST quit smoking because you are risking developing lung diseases including lung cancer by continuing to smoke. Call 1-800-QUIT-NOW or visit http://smokefree.gov To know more about electronic cigarettes, please read the document from American Thoracic Society Electronic Cigarettes
Bronchitis: Bronchitis is inflammation of bronchial tubes. It can cause cough, wheezing and shortness of breath. Bronchitis can be acute or chronic. Acute bronchitis is usually caused by viruses or bacteria and is expected to resolve completely in a few days to weeks. If you believe you have acute bronchitis, please see your medical provider so that you can receive evaluation and treatment appropriate for your condition. Chronic bronchitis is described below. To learn more about Bronchitis, please visit National Institute of Health’s Bronchitis page
Asthma: Our airways constrict if they are exposed to something that they perceive as harmful. This causes cough, shortness of breath, chest tightness and wheezing. Some people may have only one while others may have two or more symptoms. Once the constriction resolves usually with removal of the exposure and/or with medications, symptoms resolve and patient’s breathing returns to normal until another exposure causes airway constriction and symptoms. This is called Asthma. If you are having an Asthma attack wherein the airways have constricted so much that you can not breath, call 911 immediately. Once your Asthma attack has been treated and you are back to normal, you should take medications prescribed by your doctor to prevent another attack in future. You should also try to identify the exposures that activate your Asthma. Once you know what activates your Asthma, avoiding them will keep you from having an Asthma flare up or attack. To learn more about Asthma, please visit National Institute of Health’s Asthma page
COPD/Emphysema/Chronic bronchitis: Unlike Asthma (see above) wherein airways are in normal healthy state in between Asthma flare ups, in COPD, airways have permanent damage thus continue to have some degree of structural abnormality even in between COPD flare ups. Thus during a flare up, patients with COPD and Asthma have similar symptoms of cough, shortness of breath, chest tightness and wheezing but while a patient with Asthma is likely to return to normal breathing in between the flare ups, a patient with COPD will continue to have one or more of these symptoms to some degree depending on the severity of permanent damage. Emphysema and Chronic bronchitis are two different types of COPD diseases. COPD patients with permanent damage mainly to their bronchial tubes tend to have nearly daily productive cough and are diagnosed to have Chronic bronchitis. While COPD patients with permanent damage mainly to their lungs tend not to have much of cough or mucus and are diagnosed to have emphysema. Sometimes it is difficult to label a COPD patient as Chronic bronchitis or Emphysema. Since treatments are mostly similar, going out of the way to find the exact label is not important. Most common cause of COPD in US is cigarette smoke although exposure to any airway irritant over a long period can lead to COPD. One important genetic cause of COPD, mainly Emphysema type, is low levels of Alpha-1 Antitrypsin enzyme. This should be particularly suspected if someone with no history of exposure to cigarette smoke is diagnosed with Emphysema. It can be diagnosed with a blood test. To learn more about COPD, please visit National Institute of Health’s COPD page and refer to these documents from American Thoracic Society COPD – Introduction, COPD – Exacerbations and COPD – Medicines
Bronchiectasis: Bronchiectasis is abnormal permanent widening of the airways, often a consequence of repeated infections damaging airways’ muscles, elastic tissue and cilia making them flabby with formation of pouches in their walls. Mucus can collect within the airways and pouches and due to the lack of cilia, it cannot be pushed out. This creates the ideal breeding ground for infections. Bronchiectasis is different from bronchitis in that bronchitis is inflammation of the walls of the bronchi and bronchioles which causes narrowing. Bronchiectasis on the other hand is a widening of the bronchi and bronchioles although excessive mucus production does narrow the bronchial tree. To learn more about Bronchiectasis, please visit National Institute of Health’s Bronchiectasis page
Pneumonia: Pneumonia is infection of the lungs wherein air sacs get filled with pus or fluid. Based on radiographic appearance, it can be divided into Lobar Pneumonia wherein an entire lobe is involved (mostly pneumococcal pneumonia and has a rapid onset of symptoms) and Bronchopneumonia wherein alveolar involvement is patchy and there may also be involvement of adjacent bronchioles and bronchi (onset of symptoms is not as dramatic as with lobar pneumonia). To learn more about Pneumonia, please visit National Institute of Health’s Pneumonia page
Nontuberculous mycobacteria: Nontuberculous mycobacteria (NTM) is a group of bacteria normally found in soil and water. One can get exposed to them by inhaling them in the air or water mist or from drinking water containing NTM. Although NTM is not able to establish disease in most people with normal immune system, it can establish disease in some with chronic lung diseases such as COPD, Bronchiectasis or those with immune deficient conditions such as AIDS. Patient with NTM lung infections usually have cough, loss of appetite, loss of weight etc. It is treated with medicines that are used for treatment of Tuberculosis. However, NTM is not spread from person to person like Tuberculosis is. To learn more about Nontuberculous mycobacteria, please visit American Lung Association’s NTM page
Sarcoidosis: Sarcoidosis is an inflammatory disease. We don’t know what causes it. What we know is that patients with Sarcoidosis have lesions formed by their immune system as if it is trying to contain/fight “something” there. We don’t know what this “something” is that immune system is trying to contain/fight. There are theories but no body knows for sure. Sarcoidosis lesions can form in any part of the body. Symptoms of Sarcoidosis depend on the part of body the lesions are forming in. Most often these lesions form in the lungs. Patients with Sarcoidosis involving the lungs usually have cough and shortness of breath. We treat Sarcoidosis by using medicines to suppress the inflammation and keep the lesions from forming. To learn more about Sarcoidosis, please visit National Institute of Health’s Sarcoidosis page
Pulmonary Embolism: Pulmonary embolism is blockage of blood flow to a portion or entire lung(s) by a blood clot that most of the times originates in the legs, breaks loose, travels in the blood stream and gets lodged in a lung artery causing blockage of blood flow to the lung. It can cause sudden death if it gets lodged in a central location blocking blood flow to both lungs. Symptoms vary depending on the site of blockage but usually consist of sudden shortness of breath, chest pain, dizziness, passing out etc. Since it is a life-threatening condition, if you suspect you may have Pulmonary Embolism, you must call 911 immediately. To learn more about Pulmonary Embolism, please visit National Institute of Health’s Pulmonary Embolism page
Pulmonary Hypertension: Pulmonary hypertension is increase in pressure in the pulmonary arteries (blood vessels that carry blood from right side of the heart to lungs to pick up oxygen from the lungs). This is not as common and is different from the systemic hypertension that people often call as having “high blood pressure”. Pulmonary hypertension causes shortness of breath and the degree of shortness of breath varies with the degree to which pressure is increased in the pulmonary arteries. Pulmonary hypertension is usually suspected based on heart ECHO test and the diagnosis is confirmed by right heart catheterization. There are several causes for Pulmonary Hypertension. They are grouped into 5 groups by WHO. Of these Group 1 is called Pulmonary Arterial Hypertension. It is not a common disease. These patients usually have proliferative vasculopathy of the small muscular pulmonary arterioles that is characterized by medial hypertrophy, intimal hyperplasia and plexiform lesions. Treatment of this group requires special medications and these patients are usually referred to specialty clinics at university medical centers. To learn more about Pulmonary Hypertension, please visit National Institute of Health’s Pulmonary Hypertension page
Interstitial Lung Disease: Interstitial lung disease is a group of inflammatory diseases in which the site of inflammation is lung tissue. In some of these diseases, cause of inflammation is not known (eg Idiopathic Pulmonary Fibrosis) while in others the cause can be reasonably suspected (eg Radiation, drugs, mold etc). Symptoms are usually of cough and shortness of breath. Treatment varies depending on the exact diagnosis. To learn more about Interstitial Lung Disease, please visit National Library of Medicine’s Interstitial Lung Disease page
Lung Cancer: Lung cancer occurs when a normal cell becomes abnormal, starts multiplying out of control disrupting the normal structure and function of the lungs causing symptoms, disease and if continues unchecked eventually death. Cigarette smoking is most common cause of lung cancer. Most common symptoms are cough, shortness of breath, chest pain, wheezing, coughing up of blood. In many patients by the time symptoms develop, the cancer is already in an advanced stage. If you smoke, best prevention against lung cancer is to quit smoking. To learn more about Lung Cancer, please read this Lung Cancer Document by American Thoracic Society and visit National Cancer Institute’s Lung Cancer page
Work-Related Lung Diseases: Certain occupations place people at risk of developing lung diseases. Please read this Occupational Lung Diseases Documentfrom American Thoracic Society for more information.
Respirator Mask: A respirator mask may be helpful in protecting your lungs when working in dusty environment. Please read this Disposable Respirator Document from American Thoracic Society for more information.
Flexible Bronchoscopy: In flexible bronchoscopy procedure, a fiber optic light instrument is inserted via the mouth or nose and advanced to examine the airways for any abnormalities and to collect specimens including biopsies of any visible abnormalities and of abnormalities not directly visible during the procedure but known to be in certain chest areas based on earlier imaging studies such as CXR and/or CT scan. The procedure is performed with patient under sedation. Patient is asked to not eat or drink anything usually after mid-night before the procedure to reduce the risk of throwing up and aspirating during the procedure. Patient may also be asked to stop any blood thinners he may be on to reduce the risk of bleeding. Although a relatively safe procedure, there are risks associated with the procedure such as worsening of breathing during or immediately following the procedure, bleeding, collapse of lung. If there are no complications, patient is discharged to home after the procedure. However, patients will need to arrange to have someone drive them back from the hospital after the procedure because of having received sedation for the procedure. If specimens were collected during the procedure, results are usually available within about a week. Please also read this Bronchoscopy Document from American Thoracic Society for more information.
Thoracentesis: In Thoracentesis procedure, fluid is removed from the sac around the lung with a needle and catheter under local anesthesia. Main risk of this procedure is bleeding and collapse of lung. A chest x-ray is performed after the procedure to ensure lung did not collapse during the procedure. If there is no complication, patient is discharged to home after the procedure. Please read this Thoracentesis Document from American Thoracic Society for more information.
Pulmonary Function Tests: Pulmonary function test is performed to measure the function of the lungs. It allows to establish the severity of lung disease. It is different from breathing treatment. Please read this Pulmonary Function Test Document from American Thoracic Society for more information.
How to use Metered Dose Inhaler: Please read this Using Metered Dose Inhaler Document from American Thoracic Society for information on Metered Dose Inhalers and how to use them properly.
Pulse Oximetry: Pulse oximetry is measuring Oxygen level in blood using a small device without having to take a blood sample. Please read this Pulse Oximetry Document from American Thoracic Society for more information.
Oxygen Therapy: If oxygen level in your body is low, you may need supplemental Oxygen. Please read this Oxygen Therapy Document from American Thoracic Society for more information.
Pulmonary Rehabilitation: Pulmonary rehabilitation is a very important component of maximizing function in patients with chronic lung diseases. Please read this Pulmonary Rehabilitation Document from American Thoracic Society for more information.
How lungs work: Lungs are vital organs for sustaining life. To learn about how lungs work and the role they play in sustaining life, please visit National Institute of Health’s How Lungs Work page
Obstructive Sleep Apnea Syndrome: Obstructive sleep apnea syndrome is a common and underdiagnosed problem in both adults and children. It is characterized by decrease or complete cessation of airflow for several seconds due to obstruction of the airway occurring repeatedly throughout the sleep. It has profound adverse effects in several areas not only during sleep but also during awake period and not only short term consequences but long term consequences resulting in chronic diseases from cumulative effect of untreated obstructive sleep apnea over years. Please read Sleep Apnea in Adults Document and Sleep Apnea in Children Document from American Thoracic Society and visit National Institute of Health’s Sleep Apnea page for more information.
Insomnia: Insomnia is inability to initiate or maintain sleep. It is normal to not be able to sleep occasionally or during a period of stress. It becomes a problem if patient is not able to sleep adequately on most nights and it affects patient’s functioning during the day. Please read this Insomnia Document from American Thoracic Society for more information.
Restless Legs Syndrome: Restless Legs Syndrome is characterized by an urge to move legs particularly when sitting still and close to bedtime. It can be severe enough to affect ability to go to or maintain sleep. Please read this Restless Legs Syndrome Document from American Thoracic Society for more information.
Periodic Limb Movement Disorder: Periodic Limb Movement Disorder is similar to Restless Legs Syndrome except that the leg movements occur during sleep without patient being aware of them. These are picked up during a sleep study.
Narcolepsy: Patients with Narcolepsy have periods of uncontrollable urge to sleep be it for few minutes throughout the course of day even if they sleep well at night. Some also develop sudden muscle weakness during a strong emotion such as laughing, anger. Symptom will depend on the muscle group involved. If leg muscles are involved, patient may fall. If hand muscles are involved, they may drop what they were holding in that hand. Please visit National Institute of Health’s Narcolepsy page for more information.
REM Behavior Disorder: Most of dreams, particularly vivid dreams occur during REM sleep. Even though many of these dreams are filled with action, we do not physically act them out because during REM sleep although our brain is fully active but our body is paralyzed. In patients with REM behavior disorder, paralysis is either incomplete or absent during REM sleep. Therefore as the brain start forming a dream full of action, the body is free to act it out and patient is not aware of the action being performed as he is not in the wakeful state. If the dream is violent, patient may hurt himself or others depending on the contents of the dream. Please visit American Academy of Sleep Medicine’s RBD page for more information.
Sleep study: Sleep study is recording of several sleep and non-sleep parameters while patient is sleeping which is later reviewed and interpreted by a physician to diagnose problems that occur during sleep. It is often done to diagnose Obstructive Sleep Apnea Syndrome, Narcolepsy and other sleep disorders. Please read this Sleep Study Document from American Thoracic Society for more information.
CPAP: CPAP is the device most commonly used for treatment for Obstructive Sleep Apnea Syndrome. Please read this CPAP Document from American Thoracic Society for more information.