Pulmonology focuses on diagnosing and treating lung and airway conditions such as asthma, COPD, and pneumonia, as well as overall respiratory health.
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The clinical presentation of emphysema is often insidious, with symptoms developing slowly over decades. Many patients adapt their lifestyle to accommodate their declining lung function, usually not realizing the severity of their condition until significant lung tissue has been destroyed. The hallmark symptom is progressive dyspnea, or shortness of breath. Initially, this may only present during heavy exertion, such as climbing stairs or carrying groceries. As the disease advances, breathlessness occurs with minimal activity, such as bathing or dressing, and eventually persists even at rest. This progression is driven by the dynamic hyperinflation of the lungs, which restricts the diaphragm’s ability to move and ventilate the lungs efficiently. At Liv Hospital, we emphasize recognizing these early functional limitations to facilitate earlier intervention.
Classically, patients with predominant emphysema have been described as “Pink Puffers.” While this terminology is somewhat dated, it accurately describes the physiological compensation mechanisms at play.
While shortness of breath is the primary complaint, other respiratory symptoms are common and can vary depending on the degree of airway involvement.
Cigarette smoking is the indisputable leading cause of emphysema, accounting for the vast majority of cases. The relationship between smoking and lung destruction is dose dependent.
This genetic risk factor is critical to identify, as it represents a distinct pathway to the disease that requires specific management.
Long-term exposure to lung irritants in the workplace or environment can cause or accelerate emphysema, acting either independently or synergistically with smoking.
The risk of emphysema increases with age due to cumulative exposure effects and the natural loss of lung elasticity over time (senile emphysema).
Events that occur early in life can set the stage for emphysema in adulthood by preventing the lungs from reaching their full potential.
Certain connective tissue diseases are associated with an increased risk of emphysema, independent of smoking, due to defects in the structural proteins of the lung.
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CT scans use X-rays to create detailed cross-sectional images and are excellent for visualizing kidney stones, detecting tumors, and evaluating traumatic injuries. They are fast and widely available. MRI uses strong magnetic fields and radio waves to produce detailed images of soft tissues, making it superior for staging prostate cancer, evaluating bladder wall invasion, and assessing pelvic floor disorders without ionizing radiation.
Contrast dye, usually iodine-based, is injected into a vein to highlight the blood vessels and urinary tract organs. As the kidneys filter the dye from the blood, it opacifies the urine. This allows the radiologist to see the internal structure of the kidneys, the ureters, and the bladder clearly, revealing blockages, tumors, or structural abnormalities that would be invisible on a non-contrast scan.
Multiparametric MRI is an advanced imaging technique that combines standard anatomical sequences with functional sequences like Diffusion-Weighted Imaging and Dynamic Contrast-Enhanced imaging. This provides a comprehensive assessment of the prostate, allowing doctors to distinguish between benign conditions like BPH and significant prostate cancer, and to guide targeted biopsies.
CT scans do involve exposure to ionizing radiation, which carries a small theoretical risk of cellular damage over time. However, modern CT scanners use dose-modulation technology to minimize this exposure to the lowest level necessary for a diagnostic image. The benefit of an accurate and timely diagnosis for serious urological conditions typically far outweighs the minimal risk of radiation.
Many modern orthopedic implants are MRI-safe, although they may cause some image distortion. However, older pacemakers, defibrillators, and certain metal clips may be unsafe in the strong magnetic field. It is critical to inform the imaging team of any metallic implants so they can verify their safety compatibility or recommend an alternative test like a CT scan.
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