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Chronic Obstructive Pulmonary Disease (COPD), Acute Exacerbation,…
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Acute Exacerbation
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Symptoms:
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- Increase sputum production and change in sputum colour
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- Increased wheeze and chest tightness
- Upper respiratory tract symptoms
- Reduced exercise tolerance
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Differential diagnosis
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- Cardiac ischaemia or arrhythmias
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Follow up
Follow up who have had an exacerbation after 6 weeks to reassess residual or changed symptoms and optimize management
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This is a sustained worsening of symptoms from their usual stable state which is acute in onset. Exacerbations can be triggered by a range of factors in respiratory tract infections, smoking, and environmental pollutants.
Spirometry
- Carry out 15-20 minutes after inhalation of a short acting bronchodilator
- Airflow obstruction is defined as a post bronchodilator ratio of forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC) of less than 0.7
-Other causes should be considered in older people with ratio below 0.7 but do not have typical symptoms of COPD
- COPD should be considered in younger people with symptoms even if ratio is above 0.7
- Grade appropriately where FEV1/FVC ratio is less than 0.7
- Should be performed at diagnosis, when diagnosis is reconsidered and for monitoring severity of disease/progression
Cor Pulmonale
- Right sided heart failure secondary to lung disease and is caused by pulmonary hypertension as a consequence of hypoxia.
- Suspect in those with: Peripheral oedema, raised JVP, systolic parasternal heave, a loud pulmonary second heart sound or hepatomegaly.