Symptoms of lung disease can be varied and a patient of lung disease may present with multiple symptoms or combination of symptoms.
Moreover these symptoms of lung disease may overlap with some symptoms of heart diseases as well.
There are several symptoms that are common in patients with cardiopulmonary disease.
Cough is required for self cleansing of the airways but may be secondary to inflammation or irritation of the airways lining. This symptom readily brings attention to the lungs.
Cough can be acute or sudden onset as well chronic. Smokers particularly have chronic cough.
An acute cough is difficult for the patient to ignore, in contrast to a chronic cough which the patient may feel is customary or habit. This is particularly true of the smoker’s cough.
Another things to probe about cough are
Circumstances of the cough
Does the cough only occur with exercise, weather changes, or exposure to suspected allergen ?
This type of coughing might occur in a patient with bronchospasm or asthma.
A cough that occurs with change in body position suggest a chronic bronchitis or bronchogenic carcinoma.
Character of the cough
Is it dry or productive?
A dry cough is the one which is not associated with phlegm production and is often described as barking, brassy, or hoarse.
It is usually is indicative of an acute irritative process. The cough may occur in response to inhalation of noxious fumes or in an allergic phenoemenon.
It could also be due to viral infection.
A neoplasm in the respiratory tree, benign or malignant, would lead to coughing by direct mechanical irritation of the respiratory tissues and thus cough receptor stimulation.
A productive cough is a cough that produces pulmonary secretions; that is recognized easily by its longer duration and distinctive sound. A productive cough persisting for months or years which is worse in the morning is suggestive of chronic bronchitis.
Chronic bronchitis is found in smokers.
Bronchiectasis is a disease that causes dilatation of the bronchial tubes is also associated with chronic cough and sputum production.
A profuse amount of secretions is produced each day.
Acute purulent cough suggests infection. Gram staining is the simple procedure to look for infecting microbes on sputum sample.
Dyspnea means difficult breathing and is perceived by the patient as “smothering or feeling of tightness in the chest.
There would be shortness of breath. Sometimes the patient may not be actually aware of the shortness of the breath.
Depending on the cause, the dyspnea may occur at rest, with exertion only or in lying position.
Dyspnea may also be psychogenic, as when associated with hysterical hyperventilation.
In patients with lung disease, dyspnea usually is due to a disorder which results in an increased work of breathing, such as restrictive defects that decrease the compliance of the lungs or chest wall, or obstructive defects with partial airways obstruction.
Restrictive lung disease can lead to intense dyspnea, especially with exertion. Obstructive defects lead to dyspnea dure to the increased resistance to air movement through the airways. This increases the work of breathing and causes the patient to feel dyspnea.
Hemoptysis means coughing up blood. It is a symptom that should never be ignored since serious lung or cardiac disorders, can cause hemoptysis. It is also important to determine whether the lungs actually are the source of the blood reported.
Chest pain is most often thought as of cardiac origin but may be due to lung disease as well.
Chest pain due to lung is due to stimulation of pain fibers in the chest wall and/or parietal pleura. Pleuritic chest pain present during inspiration and located laterally. The pain is usually sharp, severe, and located at the site of the irritative process. The pain is lessened by lying on the affected side as that decreases movement of that side of the chest.
Airway inflammation may lead to a pain described as a burning sensation and usually is pinpointed as retrosternal. Such causes of treacheal irritation as viral tracheitis, exposure to extreme cold, and inhalation of noxious fumes lead to pain of this type.
These are symptoms which a could be present along the symptoms described and could point to a respiratory problem. These are of hoarseness, wheezing, or peripheral edema of the lower extremities.
If a patient presents with symptoms of lung disease, following information should be sought further
The patient’s occupational history can be very important. Has the patient been in contact with coal, asbestos, or silica? The dust of these materials can lodge in the airways and lungs causing significant diseases over time.
Other occupational exposures could molds, pigeons, solvents, paints, etc. geographical history much include travel, immigration, and region of permanent residence. This is especially important if one suspects diseases such as coccidioidomycosis, tuberculosis, or histoplasmosis.
Tobacco smoke inhalation, either primary or secondary, is clearly the leading cause of respiratory disease in adults. The amount of cigarettes smoked usually is recorded by “pack years.” This is determined by multiplying the number of packs smoked daily by the years smoked. The more “pack years,” the greater the risk of disease.
The family history of asthma, premature emphysema, chronic bronchitis, cardiac disease, and cystic fibrosis. The social history may identify the excessive use of alcohol. Alcoholism can be associated with periods of loss of consciousness, a decreased efficiency of lung defense mechanisms, with consequent predisposition to aspiration pneumonia as well as bacterial pneumonias of the usual type.
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