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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Lung disease represents a vast, complex, and heterogeneous spectrum of disorders that compromise the structure and function of the respiratory system, a vital network of organs and tissues responsible for the life-sustaining exchange of oxygen and carbon dioxide. While often colloquially grouped under a single umbrella, lung diseases encompass a wide array of conditions ranging from transient, self-limiting infections to chronic, progressive, and life-limiting illnesses. The pathology can originate in various components of the respiratory tract: the conducting airways (trachea, bronchi, bronchioles), the gas-exchanging lung parenchyma (alveoli and interstitium), the pulmonary vasculature, the pleura, or the neuromuscular apparatus of the chest wall that drives breathing. The common denominator across these diverse conditions is the impairment of gas exchange, leading to hypoxemia (low blood oxygen), hypercapnia (high blood carbon dioxide), or both.
At Liv Hospital, we approach lung disease not as a monolithic entity but as a nuanced field requiring precise phenotyping, identifying the specific biological, physiological, and radiological characteristics of each patient’s condition to tailor personalized therapeutic strategies. This involves understanding the intricate interplay between genetic predisposition, environmental exposures, microbiome interactions, and immunological responses that drive disease onset and progression.
To truly understand the definition of lung disease, one must appreciate the specific anatomy it affects. The respiratory system is divided into functional zones, each susceptible to unique pathologies.
These conditions affect the tubes that carry oxygen and other gases into and out of the lungs. The pathology typically involves narrowing, blockage, or inflammation of these conduits.
Bronchiectasis: A condition defined by permanent, abnormal dilation and distortion of the bronchi, leading to impaired mucociliary clearance, chronic infection, and a vicious cycle of inflammation.
Bronchiolitis: Inflammation of the small airways (bronchioles), often seen in infants due to viral infection (RSV) or in adults as a serious complication of lung or stem cell transplantation (bronchiolitis obliterans).
These diseases affect the air sacs (alveoli) where the critical process of gas exchange occurs.
Pulmonary Edema: The accumulation of fluid in the alveoli, which can be due to heart failure (cardiogenic) or direct lung injury (non-cardiogenic, like Acute Respiratory Distress Syndrome – ARDS).
These affect the interstitium, the thin, lace-like layer of tissue between the alveoli, which contains blood vessels and connective tissue support.
Pneumoconiosis: Occupational lung diseases caused by the chronic inhalation of inorganic dusts like silica, coal, or asbestos, leading to specific patterns of inflammation and fibrosis.
These affect the blood vessels within the lungs, disrupting the “perfusion” side of the ventilation/perfusion equation.
Pulmonary Hypertension: High blood pressure in the arteries to the lungs, forcing the right side of the heart to work harder against resistance, eventually leading to right heart failure (cor pulmonale).
Clinically, lung diseases are often categorized by their effects on lung function tests (spirometry), which guide diagnosis and management.
Restrictive Lung Disease: Defined by difficulty in expanding the lungs. The total volume of air the lungs can hold (Total Lung Capacity) is reduced. This can be due to stiffness of the lung tissue itself (intrinsic restriction, such as fibrosis) or limitations of the chest wall (extrinsic restriction, such as obesity, scoliosis, or neuromuscular weakness).
Lung diseases are a leading cause of morbidity and mortality worldwide. They impose a massive, growing burden on healthcare systems and individuals, causing significant disability, premature death, and substantial economic costs. The World Health Organization consistently ranks COPD, lower respiratory infections, and lung cancer among the top causes of death globally. The impact extends far beyond physical health, often leading to social isolation, anxiety, and depression due to the severe limitations imposed by breathlessness and fatigue. Understanding the scope of this burden underscores the critical importance of early detection, prevention, and the comprehensive management strategies championed at Liv Hospital.
Most lung diseases involve a dysregulated or maladaptive immune response.
Autoimmunity: In some ILDs, the immune system mistakenly attacks the lung tissue, driving progressive fibrosis and loss of function.
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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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