Dr Amit Patel

Dr Amit Patel
Pulmonology and respiratory medicine
Central London


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Dr Amit Patel

Pulmonology and respiratory medicine in
London

MBBS MD FRCP AHEA

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Dr Amit Patel areas of expertise:

Professional statement

Dr Amit Patel is a leading London Consultant Respiratory physician specialising in the investigation and management of all respiratory diseases including acute and chronic cough, asthma, breathlessness of unknown cause, COPD, lung cancer, respiratory failure, sleep apnoea, sarcoidosis, interstitial lung disease and bronchiectasis, and is the clinical lead for respiratory medicine at King's College Hospital, London.

He has a number of private clinics in London, alongside his NHS work at King's College Hospital and Guys and St Thomas's Hospital. During Dr Patel's higher specialist training he obtained an MD in the Division of Asthma, Allergy, and Lung Biology within King’s College London.

Dr Amit Patel holds a postgraduate teaching qualification and is actively involved in undergraduate and postgraduate teaching and teaches all aspects of respiratory medicine. He has been involved in a number of research projects and his work has been published in a number of high impact factor international journals, and presented at major symposia in North America, Europe and the UK.

 Doctor's articles

pulmonary fibrosis treatment
Pulmonary fibrosis – the symptoms to ...

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 Credentials

GMC: ‍6029386

 Professional experience

• More than 15 years of experience
• Consultant Respiratory Physician, London Bridge Hospital (present)
• Consultant Respiratory Physician, Bupa Cromwell Hospital (present)
• Consultant Respiratory Physician, King Edward VII Hospital (present)
• Consultant Respiratory Physician, Lister Hospital (present)
• Consultant Respiratory Physician, Hospital of St John and St Elizabeth (present)
• Consultant Respiratory Physician, King's Private, King's College Hospital (present)
• Consultant Respiratory Physician, King's College Hospital NHS Foundation Trust (present)

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 Sub-specialties

• Acute and chronic cough
• Shortness of breath
• Asthma
• Respiratory infection
• Interstitial lung disease
• Sleep apnoea
• Sarcoidosis
• Lung cancer and pulmonary nodules
• COPD
• Bronchiectasis
• Chronic bronchitis
• Pleural effusion
• Pneumonia
• Pulmonary embolism
• Pulmonary emphysema
• Pulmonary fibrosis
• Pulmonary nodule
• Respiratory failure
• Smoking cessation (quitting)
• Spirometry
• Thoracic pain
• Respiratory infection
• Bronchiolitis
• Bronchoscopy
• Chest infection
• Lung biopsy
• Pulmonary hypertension
• Pulmonary tuberculosis

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 Teaching posts

• Honorary Senior Lecturer, King's College London (present)

 Education

• MBBS, King's College London (2001)
• MRCP, Royal College of Physicians (2005)
• AHEA, Higher Education Academy (2011)
• MD, King's College London (2015)
• FRCP, Royal College of Physicians (2016)

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 Publications and conferences

• Author of numerous articles published in high impact peer reviewed journals
• Regular presentations at national and international medical conferences

 Professional membership

• Fellow of the Royal College of Physicians
• Member of the British Thoracic Society
• Member of the Medical Protection Society
• Associate of the Higher Education Academy

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Languages spoken

  • English
  • Gujarati

Patient reviews for Dr. Amit Patel

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Patient reviews

Verified Patient
22/10/2018

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Patients comments

Dr patel has a wonderful bedside manner. he is approachable and reassuring. he is very thorough and takes time to expain things in clear and plain english.

Verified Patient
23/11/2017

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Diseases, Medical Tests and Treatments

Asthma

Asthma (or bronchial asthma) is a lung disease caused by narrowing of the bronchi, which causes breathing difficulties. It is characterised by the pre ...

Chronic obstructive pulmonary disease (COPD)

Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term for a group of lung conditions such as chronic bronchitis or emphysema. Among the mos ...

Cough

What is a cough? A cough can be a voluntary or involuntary action or reflex that clears the throat and airways to get rid of irritants, fluids, ...

Pneumonia

What is pneumonia? Pneumonia is an inflammatory condition of the lungs caused by infection. Primarily affecting the alveoli – small air sacs deep ...

Pulmonary Fibrosis

What is pulmonary fibrosis? Pulmonary fibrosis occurs when scar tissue builds up in your lungs, causing the lung tissue to thicken and harden. This makes it difficult to get oxygen into the blood, and so you find yourself short of breath. Symptoms of pulmonary fibrosis Pulmonary fibrosis manifests itself in the following ways: a dry cough unexplained weight loss tiredness shortness of breath muscle and joint pain swelling of the extremities of the feet or hands. However, the symptoms of fibrosis may be different in each individual, depending on the course of the disease. The progress of the disease may accelerate and worsen, but can develop more slowly in some people, taking months or years. What causes pulmonary fibrosis? There are several causes of pulmonary fibrosis. These can be classified into three main groups: Occupational and environmental factors, radiation treatments, and medication. Occupational and environmental factors: Ongoing contact with the following chemicals can damage your lungs: Silica flour, asbestos fibres, hard-metal dust, coal dust, grain dust, bird and animal droppings. Radiation treatments: People who are exposed to radiotherapy to treat lung or breast cancer may have signs of lung damage months, or in some cases, years later. The severity of the disease can vary from case to case, depending on the proportion of the lung exposed to radiation, the total amount of radiation received, whether chemotherapy was also used, or if there was a pre-existing, undetected lung disease. Medication: Many drugs can be harmful to your lungs, including chemotherapy drugs, heart medicines, some antibiotics and some anti-inflammatory drugs. However, in most cases, a cause of the disease cannot be found. This is known as idiopathic pulmonary fibrosis. Can it be prevented? The best way to prevent pulmonary fibrosis is to avoid its possible sources of infection. Avoid contact with chemicals and understand the risks and benefits of the medication you are taking. Workplaces in which employees are in contact with chemical or hazardous substances must provide protection against inhalation. What does treatment consist of? Treatment for pulmonary fibrosis can include medications, oxygen therapy, pulmonary rehabilitation and lung transplantation. Scarring of the lung tissue is not reversible, nor can the disease be stopped; it will continue to progress but at a slower rate. Some of the treatments mentioned may provide temporary improvement or slow the rate of the disease’s progression. To find out the most appropriate treatment, you need to consult a specialist in pulmonology. ...

Respiratory infection

What is a respiratory infection? An acute respiratory infection (ARI) is a disease of the respiratory tract that evolves in a period of fewer than 15 days, often turning into pneumonia. It is usually classified into three types according to the degree of complication: ARI without pneumonia ARI with mild pneumonia ARI with severe pneumonia What are the symptoms of a respiratory infection? The symptoms depend on the type of infection: ARI without pneumonia: abundant fluid in the nose, cough, fever, otorrhea (ear discharge), sore throat, dysphonia, exudate (fluid emitted through pores or a wound) in the pharynx. ARI with mild pneumonia: previous symptoms with tachypnea (increase in respiratory rate above normal values). ARI with severe pneumonia: previous symptoms with cyanosis (blue discoloration of the skin), increased respiratory distress. What are the causes of a respiratory infection? There are several factors that can cause a respiratory infection: Environmental: pollution, lack of ventilation in the home, passive smoking, sudden changes in temperature, contagion. Individual: age (affects under one-year-olds more frequently), low birth weight, previous infections, malnutrition, lack of vitamin A, not being vaccinated according to recommendations. Can a respiratory infection be prevented? Some factors may help to avoid respiratory infection in children: Breastfeed your baby for the first four to six months (if possible) Provide a healthy, balanced diet Do not smoke near children Not using charcoal or burning wood in closed places Providing the adequate clothing for the season (e.g in winter, wearing a hat and scarf) Avoiding sudden changes in temperature Giving them foods which contain vitamins A and C Ventilating rooms properly Making sure they drink plenty of fluids What is the treatment for respiratory infection? Respiratory infection is often first treated with antibiotics, and if the infection is caused by severe flu, with an antiviral medication. If the situation worsens, oxygen therapy can also be performed and, if there are complications, bronchodilator medication may be needed. ...

Breathing problems

Breathing problems can be caused by a number of conditions such as asthma, allergies, unresolved infections, COPD, and a variety of other conditions which should be checked for. ...

Bronchiectasis

What is bronchiectasis? Bronchiectasis is a chronic lung disease that damages the major airways of the lungs, causing them to widen. There can be two types: Congenital bronchiectasis: this is present from birth. Acquired bronchiectasis appears later in life. What are the symptoms of bronchiectasis? Symptoms develop gradually and may appear months or years later. The main ones are: A daily cough that occurs over months or years Coughing up large amounts of sputum (spit) with mucus Coughing up blood Wheezing Difficulty breathing, especially during exercise Chest pain Bad breath Clubbing of fingernails and toenails Fatigue Weight loss How can bronchiectasis be diagnosed? Early identification is the best way to prevent the condition from worsening. If patients have symptoms suggestive of bronchiectasis, an HRCT, blood test, sputum analysis (analysis of saliva and mucus) and lung function tests can diagnose the condition. What are the causes of bronchiectasis? Bronchiectasis can be caused by many different factors. The most common cause of bronchiectasis is recurrent respiratory tract infections. These cause inflammation and damage to the airways. Genetic causes include cystic fibrosis, which is a condition that affects the cilia, the hair-like structures that sweep mucus out of the lungs. People with a weakened immune system, asthma and primary ciliary dyskinesia are at a higher risk of developing the condition. Other causes include previous tuberculosis infections, rheumatoid arthritis and inhaling foreign bodies. Can bronchiectasis be prevented? If the disease is congenital, it cannot be prevented, although the risk of complications can be reduced by treating lung infections early. On the other hand, if a person avoids smoking and reduces their exposure to pollution, they can reduce their risk of respiratory infections. The annual flu vaccine and childhood vaccines can also help to reduce the chances of some infections. What is the treatment for bronchiectasis? The main treatment is daily drainage to eliminate sputum, the mucus that gets caught in the airways. Daily postural drainage exercises help with this. Patients are given antibiotics and expectorants to heal any chest infection. Patients who experience frequent chest infections must take prophylactic antibiotics two or three times a week.     ...

Bronchiolitis

Bronchiolitis is a viral disease characterised by swelling of the small airways. Runny nose, cough and shortness of breath are the most common symptoms. It can develop in both children and adults. However, in adult smokers it can cause serious breathing difficulties that must be treated with care. ...

Bronchoscopy

What is a bronchoscopy? This is a medical procedure performed to visualise the airways and to detect any lung disease. It may also be carried out during treatment for certain lung problems. What does a bronchoscopy involve? The device used, called a bronchoscope, is a tube measuring roughly one centimetre in diameter and around 60 centimetres in length. The bronchoscope may be flexible or rigid, but the flexible type is more commonly used. The bronchoscope is inserted through the mouth or nose and is then directed down the trachea and into the lungs. This allows an examination of the upper airways. If the bronchoscope is inserted through the mouth, a larger one can be used. Why is a bronchoscopy performed? A bronchoscopy is performed to help diagnose lung problems. The specialist may study the airways or even take a sample for further investigation. The following is a list of reasons for performing a bronchoscopy: To obtain images for studying tumours, lung tissue, or the collapse of an area of the lung. To examine the lymph nodes near the lungs. To determine why a person is coughing up blood. To find the causes of shortness of breath or low oxygen levels. To examine the airways to check for any blockages. To look for possible infection in the lungs and bronchi. To check whether there is a rejection after a lung transplant. Preparing for a bronchoscopy: The medical examination usually takes around 30 minutes. However, the time will ultimately depend on the specialist. Sometimes they may take a sample to perform a biopsy, or might come across complications during the procedure. Depending on the type of bronchoscopy, hospital admission may be necessary, particularly in the case of a rigid bronchoscopy. It is also recommended to go accompanied to the bronchoscopy, since sedation is used and you will need to be accompanied on the way home too. You should also avoid eating or drinking 8 to 10 hours prior to the procedure. What do you feel during a bronchoscopy? Initially, and until the local anaesthetic takes effect, you might feel an urge to cough or gag, due to the fluid going down your throat. You might feel pressure or a tugging sensation as the device enters the throat. You might also experience a sensation of choking or being unable to breathe. However, there is no risk of this happening, as the muscle-relaxing medications will help you feel comfortable. Finally, when the anaesthetic wears off, you might have a scratchy throat for a few days. You must not eat or drink anything immediately after the procedure. Meaning of abnormal results: The following pathologies can be diagnosed by performing a bronchoscopy: Infection caused by bacteria, viruses, fungi, parasites or tuberculosis Lung damage caused by allergic reactions Lung diseases, where the inner tissues of the lung become inflamed and damaged Lung cancer or cancer in the area between the lungs Stenosis (narrowing) of the trachea or bronchi, including severe rejection after a lung transplant. ...

Chest infection

Chest infections can be caused by bacteria, viruses, and more rarely other organisms. They cause fever, breathlessness, fatigue, and occasionally coughing up blood. ...

Chronic bronchitis

What is chronic bronchitis?    When the bronchial tubes, the breathing arteries that supply oxygen to the lungs, are inflamed, it causes bronchitis. This disease causes a phlegmy cough as well as making breathing difficult. Other symptoms include wheezing, chest tightness, and a slightly raised temperature. There are two types of bronchitis, chronic and acute.    Chronic bronchitis is classed under the umbrella term COPD (Chronic Obstructive Pulmonary Disease). When the bronchi are inflamed more mucus is produced, this is what leads to breathing difficulties and a cough. Smoking is one of the most common causes, as well as breathing in polluted air, smoke, and dust for a prolonged time.        What are the symptoms? The main symptom of chronic bronchitis is a cough that lasts a long time and doesn’t go away for several months. The cough is quite often a chesty cough, which is associated with wheezing and trouble breathing.     What causes it? Cigarette smoke is the main cause of chronic bronchitis. Inhaling smoke irritates the lungs and can cause large amounts of mucus. Chronic bronchitis can also affect people who have been exposed to chemical vapours, dust, and other airborne substances.   How can it be prevented? The best way to prevent chronic bronchitis is to never smoke or to quit smoking. The more smoke you inhale, the worse it is for your lungs. When you quit smoking, breathing will improve, as well as your cough, your lungs will begin to function better, and the chances of getting lung cancer are reduced.   Another thing that can be done is to avoid other substances that could be harmful to your health such as lacquer aerosols, spray deodorants, or spray paints. It is also advisable to avoid inhaling dust or chemical vapours. Another way to take care of your lungs is to use a mask that covers your mouth and nose when using products such as varnish, paint, or any other chemical substance with strong vapours. What is the treatment? As the name suggests, chronic bronchitis never completely disappears and it often intermittently returns for long periods of time. Treatment for chronic bronchitis can help relieve the symptoms but it does not cure them. The medications can help clear the airways and get rid of mucous. Oxygen therapy is also recommended in some cases, this kind of pulmonary rehabilitation can relieve symptoms and ensure a better quality of life.    ...

Chronic cough

What is a chronic cough? Most coughs cause discomfort, but they usually serve a use – when we cough, we expel germs, mucus and foreign material from our lungs. Most only last a short time. However, sometimes they linger for weeks or even months. A chronic cough is defined as one that lasts for eight weeks or longer in adults or over four weeks in children. They can potentially be very disruptive to the patient’s life, interrupting sleep and leading to fatigue, and in severe cases, they can cause vomiting, light-headedness, and even rib fractures. Symptoms of chronic cough: The cough itself is a symptom of an underlying condition, but it may be accompanied by other symptoms, some of which may be a result of the coughing. Stuffy nose Runny nose Post-nasal drip Sore throat Hoarseness Wheezing/shortness of breath Heartburn Sour taste in the mouth Coughing up blood What are the causes of chronic cough? There are several things that can cause a chronic cough: Asthma Chronic bronchitis Infections, e.g. pneumonia Smoking Postnasal drip Gastroesophageal reflux disease (GERD) Certain medications, e.g. ACE inhibitors for high blood pressure In rarer cases the following can also be responsible: Bronchiectasis (damaged airways) Cystic fibrosis Lung cancer Aspiration Sarcoidosis Bronchiolitis Whooping cough When to see a doctor When a cough lasts for more than a few weeks, it is worth having it checked out by a doctor. If you cough up blood, or experience weight loss, fever, or trouble sleeping, you should consult your GP or a specialist. Treatments for chronic cough Treatment for chronic cough depends largely on the cause, as treatment tends to be targeted at the underlying illness, rather than the symptom. For example, antibiotics may be prescribed to treat a bacterial infection, while asthma could be treated with steroids and/or bronchodilators. If you have a chronic cough, consult a doctor and follow their advice. Which type of specialist treats chronic cough? Specialists in pulmonary and respiratory medicine and otolaryngologists may both treat chronic cough, and other specialties may be involved, depending on the underlying cause. ...

Cystic fibrosis

What is it? Cystic fibrosis is a condition in which the lungs progressively collapse due to a build-up of thick and sticky mucus, it can also affect the digestive tube and other organs. It is one of the most common chronic lung diseases in adults and children.    This type of disease affects the lungs, the pancreas, liver, intestines, paranasal sinuses, and sexual organs. Cystic fibrosis causes mucus to be thick and sticky. It clogs the lungs, causing repeated lung infections and lung damage.     What are the symptoms?  Cystic fibrosis symptoms may develop slowly over time. Some symptoms may worsen until becoming severe. The symptoms and the seriousness of the disease may vary from person to person.     Symptoms in newborns: stunted growth.   Bowel function symptoms: Pain due to constipation, swollen abdomen due to gas, nausea, pale or clay coloured stools with mucus, weight loss. Lung and paranasal sinus symptoms: Cough, increase in mucus, fatigue, nasal congestion, pneumonia, pain in the nasal passages. Later symptoms: sterility in men, swollen pancreas, breathing issues, and finger clubbing. What causes it?      Cystic fibrosis is caused by a faulty gene that causes the body to produce a thick and sticky substance. This clogs the airways and the pancreas causing infections. It could cause serious lung infections as well as acute digestive disorders. It may affect sweat glands, the male reproductive system, and other areas.    Some people have the gene but never get any symptoms. The reason for this is that a person with cystic fibrosis must inherit two faulty genes to develop it. If they only have one, the disease won’t develop. It is more common in people of central and northern European descent.        How can it be prevented? As it is an inherited condition, it can’t be prevented. There are however some steps that can be taken to improve quality of life when affected by the condition. There is a test that can be done to check if either parent carries the gene that causes the condition, this is the closest thing to “preventing” the condition that exists. This would only be able to detect the condition, as previously stated, there is no known cure.      What is the treatment?  The key to being able to treat cystic fibrosis well is to diagnose it as soon as possible. A strong treatment plan is important to strengthen resistance to the disease and improve quality of life.  Wherever possible, patients with this condition should be in a clinic specialised in cystic fibrosis. The treatments available include: Antibiotics to prevent sinus and lung infections and to treat them if they do happen Inhaled medicines to help decongest the airways Medications to thin the mucus and expel the mucus easily Annual vaccinations     Oxygen therapy Lung transplants may be done as a last resort.     ...

Lung biopsy

What is a lung biopsy? A lung biopsy is a medical procedure performed to check lung tissue for disease or cancer. The procedure uses images to detect any abnormalities in the lung tissue, and then a small sample is removed for examination under a microscope. What does a lung biopsy involve? The procedure lasts for around 30 to 60 minutes. An imaging system may be used to visualise and identify the area chosen for the biopsy. You sit on a table with your arms outstretched, while a sedative is administered and medication is injected for localised pain. A small incision is then made in the skin, through which the needle is inserted for the biopsy, to remove a sample of lung tissue. Once the procedure is complete, the needle is removed and pressure is applied to the affected area to stop any bleeding. A bandage is then applied. After the lung biopsy, a chest x-ray is performed, and the sample obtained is sent to a laboratory for a thorough examination to determine whether any disease or pathology is present. Why would a lung biopsy be performed? A lung biopsy should be performed when there is an abnormality in the area near the lung. The main aim of a lung biopsy is to rule out cancer. The procedure is performed if abnormalities have appeared in other tests, such as a chest x-ray or chest CT scan. Preparing for a lung biopsy: Before seeing the specialist for the procedure, you need to follow some guidelines. For example, do not eat anything for 6 to 12 hours before the procedure, do not take aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, or blood thinners such as warfarin in the days prior to the biopsy. If you have any questions about taking medication, you should consult your specialist. What do you feel during the biopsy? You will be given an anaesthetic to reduce the pain. However, as soon as the biopsy needle touches the lung, you will feel pressure and pain that may last for a few moments. Meaning of abnormal results: Abnormal results from a lung biopsy may indicate the following diseases or pathologies: A viral, bacterial, or fungal lung infection The presence of cancer cells, indicating lung cancer, or mesothelioma or pneumonia. ...

Lung cancer

What is lung cancer? Lung cancer is often thought of as the most lethal form of cancer, and it is the leading cause of cancer death in the western world. There are two types of lung cancer; small cell lung cancer and non-small cell lung cancer. Non-small cell lung cancer is more common and its subtypes are; squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. What are the symptoms? There are many lung cancer symptoms, however, the most common ones are: Persistent cough. Coughing with blood or blood-streaked sputum. Chest pain that worsens when breathing deeply, coughing, or laughing. Tiredness or exhaustion. Hoarseness.    Weight loss. What causes it? The main cause of lung cancer is smoking. However, as with other types of cancer, the cause may be multifactorial and many factors could cause it to develop. The main risk factors are:  Genetic condition. Environmental factors. Active and passive smoking. A risk factor is not necessarily a cause. It may happen that some people who have all the risk factors are never affected by lung cancer but others who have no risk factors develop it.    How can it be prevented? The best way to reduce the risk is to not smoke and also avoid second hand smoke. The length of time as a smoker is a higher risk factor compared to the quantity of cigarettes smoked daily. Quitting smoking at any age can greatly reduce the risk of developing lung cancer, more so than just reducing the amount smoked. What is the treatment?   There are different treatments, some involve surgery and some don’t. There are benefits to using a combination of different treatments, such as surgical, chemotherapeutic, and radiotherapeutic treatments. Quite often treatment will involve chemotherapy and radiotherapy but avoid surgery.   Early diagnosis is important for a better prognosis, when the cancer is only a few centimetres big. In these cases, the tumour can be removed and survival and prognosis significantly improve.            ...

Lung diseases

What is lung disease? The term “lung disease” is a broad one, encompassing all conditions that prevent the lungs from working properly. There are three main types of lung disease: Diseases of the respiratory tract – these affect the airways that transport oxygen and other gases in and out of the lungs. They often cause a narrowing or blockage of the airways. Examples include asthma, pulmonary emphysema, bronchiectasis and chronic bronchitis. Diseases of the lung tissue – inflammation of the lung tissue makes the lungs unable to expand fully. Patients are unable to take deep breaths, making it difficult for the lungs to capture oxygen and release carbon dioxide. Examples of these disease include pulmonary fibrosis and sarcoidosis. Diseases of the pulmonary circulation – conditions affecting the pulmonary blood vessels in the lungs, by coagulation or inflammation. They not only prevent the capture of oxygen and release carbon dioxide correctly but also affect cardiac activity. An example of this is pulmonary hypertension.   What are the symptoms of lung disease? Some of the symptoms that are present in lung diseases are: Cough (with or without phlegm) Fatigue or tiredness Recurrent respiratory infections Difficulty breathing or dyspnoea Difficulty inhaling air Wheezing   Causes of lung disease Different diseases have different causes. Many lung disease are cause by infection by bacteria, viruses, or fungi, which may have been breathed in. to start the infection. Some, like sarcoidosis, affect multiple systems in the body. Inhaling certain substances can damage the lungs, either directly causing or becoming a contributing factor to lung disease. These include polluted air, chemical vapours, excessive dust, and tobacco smoke.   Can lung disease be prevented? The best way to prevent lung disease is quit smoking (or simply not to start in the first place). If the patient already suffers from lung disease, then they should stop smoking immediately to prevent complications and delay the progression of the disease. They should also avoid exposure to the other airborne irritants.   What is the treatment for lung disease? The basic objectives of the treatment of lung disease are: To relieve symptoms Delay the progression of the disease Improve the capacity to stay active Prevent and treat possible complications of the disease Improve the patient's health Different diseases require different treatments, ranging from medications to lung transplants depending on the nature and severity of the disease. ...

Pleural effusion

What is pleural effusion? Around the lungs, there is a thin space filled with fluid known as the pleural cavity. Pleural effusion is a build-up of excess fluid in this space, which limits the space the lungs can expand into while breathing in. The result is impaired breathing, with the patient forced to take shallower breaths. Pleural effusion is divided into two types: Transudative – the excess fluid is similar to normal pleural fluid and rarely needs to be drained unless there is a very high amount. It is usually caused by congestive heart failure. Exudative – proteins, blood, inflammatory cells and even bacteria may leak along with fluid from damaged blood cells into the pleural space. It may cause inflammation or other problems, and often needs to be drained. This type can be caused by lung cancer and pneumonia.   What are the symptoms of a pleural effusion? Although in some cases patients with pleural effusion have no symptoms, a moderately-sized or large pleural effusion may cause: Shortness of breath Chest pain, usually acute, worse when coughing or breathing deeply Cough Fever Fast breathing Difficulty breathing A doctor will usually order imaging tests such as X-rays, a CT scan, or an ultrasound scan to view the lungs and the pleural cavity in order to make the diagnosis.   Causes of pleural effusion Pleural effusion can be caused by a wide range of things: Leakage from other organs – fluid can leak from other organs and become trapped in the pleural cavity. Conditions such as congestive heart failure (in which the heart doesn’t pump blood around the body properly), liver disease, and kidney disease can all lead to this. Cancer – typically lung cancer, but metastases of other cancers can arrive at the lung too. Infections, e.g. tuberculosis, pneumonia, etc. Pulmonary embolism Autoimmune conditions, e.g. lupus, rheumatoid arthritis Complication of surgery   What is the treatment for pleural effusion? The condition that caused the pleural effusion must be diagnosed and treated to prevent any further leakage, for example, the doctor would probably prescribe antibiotics if the cause was pneumonia. If the pleural effusion is not too big or is not causing any problems, it may not require treatment. However, if it is large and/or causing problematic symptoms, the fluid can be drained, either by a needle (thoracentesis), by a tube inserted into a hole the doctor has made in the patient’s chest wall (tube thoracostomy), or by a long-term catheter if the patient suffers recurrent pleural effusions, so that they can be drained when they occur. In some cases, surgical intervention may be necessary to deal with inflammation or unhealthy tissue in the pleural cavity. ...

Pneumothorax

Pneumothorax is the presence of air in the pleural space between the lungs and chest. Symptoms generally include onset of one-sided chest pain, or shortness of breath. If the condition is not reversed, it can result in death. Pneumothorax is a collapsed lung, this blockage occurs when air leaks into the space between the lungs and chest wall. This disease affects more men than women, the risk increases if the patient is regular smoker. The origin of pneumothorax can be external by an injury or a fracture in the ribs or internal by disease in the lung itself. Symptoms of pneumothorax Difficulty breathing Pain in the chest area The racing heartbeat, Excessive sweating Paleness Bad cough sometimes with blood   ...

Pulmonary embolism

What is pulmonary embolism? Pulmonary embolism is a sudden blockage in a lung artery. When a blood clot, called a deep vein thrombosis, occurs in your leg, it breaks off and moves through the bloodstream until it reaches the lungs. Pulmonary embolism is a serious pathology that can permanently damage the affected lung. Low oxygen levels may result in damage to various organs in the body due to not receiving a sufficient amount of oxygen. In cases where the clot is large, or there are many clots, the embolism can cause death. Symptoms of pulmonary embolism In up to 50% of cases, a person with a pulmonary embolism has no symptoms. If they do have symptoms, these may include shortness of breath, chest pain, or coughing up blood. If there is a clot, the person may have symptoms such as heat, swelling, pain, tenderness, and redness of the leg. Treatment to remove these symptoms involves breaking up the clots and preventing new clots from forming. What causes pulmonary embolism? Pulmonary embolism is caused by the blockage of a blood vessel, technically known as thrombosis. The clots originate in the veins of the pelvis or the legs and are carried into a pulmonary vessel. The embolus, the part that detaches from the clot, reaches the right ventricle of the heart and continues to the right or left pulmonary artery. If an embolus is large enough it can block a blood vessel and trigger the various symptoms. In terms of risk factors, these can be acquired or genetic. Acquired risk factors include surgical operations, serious spinal injuries, medication, cancer or pregnancy. Genetic factors are inherited in your DNA, such as a greater disposition to blood clotting disorders. Can it be prevented? Pulmonary embolism can be prevented and the best ways to do this are to practice sports regularly to keep blood circulating in your legs and to avoid risk factors that influence pulmonary embolism, such as obesity. Read about managing deep vein thrombosis here. What does treatment consist of? The recommended treatment for pulmonary embolism is to use anticoagulants. Drugs such as thrombolytics or interventions such as the implantation of vena cava filters may also be used to speed up clot removal or to prevent the clot from reaching the lungs. ...

Pulmonary emphysema

Pulmonary emphysema is a type of chronic obstructive pulmonary disease (COPD). This disease occurs when the pulmonary alveoli are gradually destroyed, making it increasingly difficult to breathe. When the alveoli are destroyed, a larger space is created, instead of multiple small chambers. This affects the expansion of the lungs and the amount of oxygen that reaches the blood. What is pulmonary emphysema? This is a disease that gradually destroys the fibres that hold open the airways. When this occurs, the airways collapse when you exhale, so the air containing carbon dioxide cannot escape from the lungs and fresh, oxygen-filled air cannot enter the lungs. Symptoms of pulmonary emphysema The most common symptom of pulmonary emphysema is shortness of breath, which gradually worsens. The affected person starts avoiding activities that cause shortness of breath in order to relieve the problem. However, the disease worsens to the point that it prevents the person from carrying out daily activities. Emphysema reaches its peak when the person finds it difficult to breathe even when at maximum rest. What causes pulmonary emphysema? The main cause of pulmonary emphysema is exposure to airborne irritant, such as those listed below: tobacco smoke and marijuana air pollution manufacturing gases silica and coal dust. It can also be caused by an inherited defect, but only in a small number of cases. Can it be prevented? The best way of preventing pulmonary emphysema is not to smoke and to avoid passive smoking. It is also advisable to wear a mask if you are in contact with dust or chemical vapours in your workplace. It is recommended to follow the advice below:. Exercise regularly: Physical exercise can increase lung capacity despite breathing difficulties. Protect yourself from cold air: Cold air can cause bronchial spasms, making it difficult to breathe. Wear a scarf over your nose and mouth during the winter to warm the air you inhale. Avoid other respiratory infections: Get vaccinated against pneumonia and the flu. Avoiding contact with people with a cold or the flu is also a good preventive measure. What does treatment involve? There is no cure for pulmonary emphysema, but some treatments can relieve symptoms and slow the progression of the disease. Treatments can be divided into three groups: medication, therapy, and surgery. Medication: There are different types of medications that can reduce the severity of the symptoms. Smoking cessation medications are prescribed by a doctor and can help you to stop smoking. Bronchodilators can help alleviate coughing, shortness of breath, and breathing difficulties. Inhaled steroids, such as bronchodilators, can help relieve shortness of breath. However, it is not advisable to use these continuously because they can weaken your bones and increase the risk of blood pressure problems. Lastly, antibiotics are used if a bacterial infection develops, such as bronchitis or pneumonia. Therapy: There are two types of therapy: pulmonary rehabilitation and oxygen supplementation. The former is a rehabilitation programme that can help reduce the sensation of breathlessness and improve lung capacity. Oxygen supplementation is used with people who suffer from severe emphysema and who have low blood oxygen levels. Surgery: Similarly, there are two different types of surgery depending on the severity of the emphysema: Lung volume reduction and lung transplantation. In the former, surgeons remove small wedges of affected lung tissue. This helps the healthy lung tissue to work more efficiently and thereby improve breathing. Lung transplantation is performed if you have severe emphysema and all other treatments have failed. ...

Pulmonary hypertension

What is pulmonary hypertension?      Pulmonary hypertension is high blood pressure that affects the lung arteries and the right side of the heart. It is a serious condition in which the blood vessels that transport blood from the heart to the lungs – the pulmonary arteries – narrow, harden, are blocked, or damaged. If at higher pressure, the right ventricle has to work harder to pump blood. This weakens the heart muscle which can cause it to fail.        Pulmonary hypertension can be classified in different stages: Stage I: despite diagnosis, the patient notices no symptoms with normal activity. Stage II: the patient has no symptoms when resting, but does notice a change when performing activities. Stage III: the patient is fine when resting but has symptoms when physically active. Stage IV: the patient has symptoms when physically active and when resting.   Pulmonary hypertension can cause some complications, such as: Enlargement of the right side of the heart, causing heart failure Blood clots Arrhythmias Bleeding. Condition prognosis Prognosis varies depending on the stage of the condition. In some cases of stage III and stage IV, the disease can be fatal.     It is an incurable disease. There are many treatments available to alleviate symptoms and improve quality of life.   In recent years, big improvements have been made in how the condition is treated. New treatments have proven to be more effective, improve the quality of life, and increase life expectancy for patients.   What are the symptoms? In most cases, symptoms are only noticeable when the condition is at an advances stage. It may take months or years for the symptoms to be noticeable, which is why primary care is so important for getting an early diagnosis. As the condition progresses, symptoms get worse.   The most common symptoms with pulmonary hypertension are:    Dyspnea: shortness of breath when exercising of resting Fatigue Chest pressure Chest pain Dizziness Fainting (syncope) Swelling of the feet and legs, and eventually the abdomen Cyanosis: bluish discolouration of the lips and skin Increased heart rate Loss of appetite. Medical tests Diagnosing pulmonary hypertension is not always easy as symptoms don’t tend to appear until the disease is advanced. There are many medical tests to diagnose the condition: Echocardiogram Chest x-ray Electrocardiogram Right heart catheterisation Blood test. In order to see the condition of the patient’s lungs, there are tests to check other organs and to determine the cause of the disease. CT scan MRI scan Pulmonary function tests Polysomnography Ventilation / perfusion scan Open lung biopsy.      If a family member has had pulmonary hypertension, the specialist may analyse the genetic factors associated with it. If the result is positive, the specialist may recommend other family member to be tested.   Echocardiography is the most important test used to identify this condition in breathless patients. Many other tests (lung function, lung scans, right heart catheterisation etc.) are required to find the exact cause and give the right treatment once pulmonary hypertension is suspected. Because of the specialised nature of the testing and treatment required, all UK patients with pulmonary hypertension that is not clearly due to left heart and lung disease are referred to one of seven national specialist centres. What causes it?    The heart has four cavities: two upper chambers known as atria, and two lower chambers known as ventricles. When blood passes through the heart, the right ventricle pumps blood to the lung through the pulmonary artery.           The lungs take in oxygen and get rid of carbon dioxide, returning the oxygenated blood pulmonary veins to the heart.        In cases of pulmonary hypertension, there are changes in the cells that cover the pulmonary arteries. The walls harden or additional tissues form which can cause an obstruction.   These changes can block or reduce blood flow, raising blood pressure in the pulmonary arteries.   According to the cause, pulmonary hypertension is classified in five groups:   Group 1: Pulmonary arterial hypertension Unknown cause, known as idiopathic hypertension Specific gene mutation, hereditary pulmonary arterial hypertension Medications or drugs such as methamphetamines Congenital heart disease Connective tissue disorder, HIV, and chronic liver disease, cirrhosis. Group 2: Pulmonary hypertension caused by left-side heart disease Left valve heart disease or mitral or aortic valve disease Lower left chamber heart failure Group 3: Hypertension caused by lung disease Chronic obstructive pulmonary disease (COPD), emphysema Lung disease, pulmonary fibrosis Sleep apnea        Group 4: Pulmonary hypertension caused by chronic blood clots Embolism Group 5: Hypertension associated with other conditions Blood disorders Sarcoidosis Metabolic disorders Tumours that put pressure on the pulmonary arteries Eisenmenger’s syndrome and pulmonary hypertension Congenital heart disease that causes pulmonary hypertension. In this disease, there is a large hole between the ventricles that cause the blood to circulate abnormally.   How can it be prevented? Pulmonary hypertension is often only noticeable when the condition is at an advanced stage. There isn’t a known way to prevent it from developing, although certain risk factors should be avoided: Avoid being overweight In the event of family history of pulmonary hypertension, you should see a specialist Conditions that increase the risk of developing hypertension Consuming illegal drugs such as cocaine Appetite suppressant medication.     What is the treatment?    Pulmonary hypertension is an incurable disease. Specialists can help treat and manage the condition, treating symptoms, and slowing disease progression. Pulmonary hypertension medicines:         Blood vessel dilators Anticoagulants Diuretics Digoxin Oxygen therapy Endothelin receptor antagonists Sildenafil and tadalafil High doses of calcium channel blockers Soluble guanylate cyclase stimulator.       Surgeries: Atrial septostomy: a small hole is made in the upper chambers of the heart to alleviate pressure. It can lead to serious complications, such as arrhythmias. It is generally used when treatment with medication has not worked.   Transplant: in some cases, a heart or lung transplant is an option, especially for young people with idiopathic pulmonary arterial hypertension.    What specialist should I see? Cardiologists are the specialists who treat pulmonary hypertension regardless of age. Cardiovascular surgeons also treat this condition. A pneumologist may also be involved in treating this condition, although they are normally only involved up until diagnosis.    ...

Pulmonary nodule

What is a pulmonary nodule? Pulmonary nodules are spots on the lungs, which usually are no larger than 3cm in diameter. In most cases, they are benign and do not represent cancer. A pulmonary nodule will usually show on a chest x-ray or a CT scan. They can appear as individual nodules, or you may have several. If a pulmonary nodule is cancerous, they are usually larger than 3cm and may be irregular in shape. Prognosis of a pulmonary nodule: Benign pulmonary nodules are more likely to be non-cancerous is you are a non-smoker, you are less than 40 years of age and the nodule is less than 3cm. If the nodule is confirmed as being cancerous, if there is just one nodule it is likely that the lung cancer is in earlier stages. However, a cancerous pulmonary nodule could be indicative of a metastasis from cancer that originated elsewhere in the body. This will mean a later stage cancer which will be treated accordingly. Symptoms of a pulmonary nodule: Pulmonary nodules are generally symptomless and you may have had a pulmonary nodule on your lung for months or years. If the nodules are cancerous, you may be experiencing symptoms related to the type of cancer in question, such as a cough and difficulties breathing. Medical tests to diagnose a pulmonary nodule: A chest x-ray or CT scan will usually indicate a pulmonary nodule, which may be performed if you have visited the doctor for respiratory symptoms or illness, such as a persistent cough. Once identified, your medical history will be assessed and whether you smoke or not. To determine if a nodule is cancerous a biopsy can be taken which can be carried out as a bronchoscopy or a needle biopsy. A PET scan may be performed to indicate whether the cells making up the nodule are dividing quickly, which would indicate cancer. Blood tests may also be carried out. What are the causes of a pulmonary nodule? Generally a benign pulmonary nodule will develop as a result of inflammation or scarring on the lungs. The following can cause this: Infections (e.g. tuberculosis) Neoplasms (abnormal growths that can be cancerous or non-cancerous) Rheumatoid arthritis Sarcoidosis Lung cancer Metastatic tumours Can pulmonary nodules be prevented? You can reduce the risk of pulmonary nodules forming by quitting smoking. Treatments for a pulmonary nodule: If the pulmonary nodule is benign, you will be advised to have regular check-ups to track any growth or change in the nodule. Sometimes a benign nodule can be removed surgically. If the pulmonary nodule is cancerous, cancer treatment will start and surgery will be considered to remove the cancerous growth. Which type of specialist treats pulmonary nodules? A pulmonary and respiratory medicine specialist would treat pulmonary nodules. ...

Pulmonary tuberculosis

What is pulmonary tuberculosis? Pulmonary tuberculosis is a bacterial infection that affects the lungs and can spread to other organs. The bacteria can be spread from an affected individual to another person. The infection can be transmitted by inhaling water droplets when an infected person coughs or sneezes. Symptoms of pulmonary tuberculosis Pulmonary tuberculosis can cause a wide variety of symptoms: breathing difficulties chest pain coughing up mucous or blood excessive sweating, especially at night fatigue fever weight loss wheezing Causes of pulmonary tuberculosis The main cause of pulmonary tuberculosis is through inhaling tiny droplets of saliva from an infected person. These particles reach the deepest parts of a healthy person's lungs and cause infection. Cases of pulmonary tuberculosis are higher in poorer areas of the world, particularly where there is overcrowding, as the bacteria can easily spread in a closed and poorly ventilated space. How is it diagnosed? The skin test is the most common way to diagnose pulmonary tuberculosis. This involves injecting a very small amount of tuberculin just beneath your skin and waiting to see if there is a reaction. A positive test result (swelling or a hard bump) is evidence that you have the TB bacteria in your body. However, this is not conclusive proof that you have tuberculosis. You are likely to have a follow-up X-ray to see if there is an infection in your lungs. What does treatment consist of? The ultimate goal of the treatment is to cure the disease, and different medicines are used over a long period of time. The medical tests performed when the disease was first detected will determine what type of medication should be taken. Time limits and tablet dosage must be strictly adhered to, as failure to do so can lead to drug resistance and can make it more difficult to eliminate the infection from the body. In any case, the specialist will recommend when it is safe to end treatment. ...

Respiratory failure

What is respiratory failure? Respiratory failure is a condition that affects the respiratory system when it doesn’t provide enough oxygen to the blood or when the lungs can’t properly eliminate carbon dioxide. It can be acute or chronic. When it appears for a limited period of time (maximum one hour), it is an acute condition; if it develops over a few days, it is considered chronic. The most common type is hypoxemic respiratory failure, and it affects the lungs (lung oedema, pneumonia, pulmonary embolism, pulmonary fibrosis). What are the symptoms? The main symptoms are: Irregular breathing or gasping Tachycardia Overuse of respiratory muscles (e.g. the diaphragm) Tachypnoea Decreased lung capacity How is respiratory failure diagnosed? Various tests are needed to identify the underlying cause of the condition. These tests include: Electrocardiogram - to check the heart rhythm Blood tests - to measure the amount of oxygen and carbon dioxide in the blood Pulse oximetry test – to measure how much oxygen the blood is absorbing What are the causes? The causes can vary depending on the severity of the illness. The main reasons are: Asthma Bronchitis Pulmonary pathology Cardiovascular disease Pneumonia Obesity Pulmonary hypertension Alcohol and drug abuse Poisoning Hypothyroidism Muscular damage Spinal lesions What is the treatment? The treatment used for respiratory insufficiency aims to improve the hypoxemia, correct the acidosis and improve the cardiac activity. The use of a particular treatment will depend on the type of respiratory insufficiency (acute or chronic). The most frequent treatment used to supply oxygen is the nasal cannula or the face mask, and in some instances, mechanical ventilation, which is used to improve oxygen levels and to reduce the need of oxygen in the respiratory muscles. What specialist should you visit? Respiratory medicine specialists diagnose and treat diseases and conditions of the respiratory system. ...

Sarcoidosis

What is sarcoidosis? Sarcoidosis is a rare condition that affects multiple organs in the body but mostly the lungs and the lymph glands. It causes small patches of red and swollen tissues known as granulomas. Many people with sarcoidosis usually find that their symptoms improve without treatment over a few months or years. For those who find their symptoms have become worse are severely affected and have what is referred to as chronic sarcoidosis.   How is it caused? The cause of sarcoidosis is not known and the trigger is uncertain. It may be a type of autoimmune disease associated with an abnormal immune response. Normally, the body’s immune system releases white blood cells into the blood to isolate and destroy germs where there is an infection. This creates inflammation of the body tissues. The immune system then responds to anything in the blood that it does not recognise and calms down once the infection has been cleared. In cases of sarcoidosis, the immune system has gone into overdrive and the body attacks its own tissues and organs. This causes the granulomas to develop in the organs. It is not known why the immune system behaves like this. Some environmental factors may trigger the condition.   What are the symptoms of sarcoidosis? The symptoms can vary, depending on which organs are involved. Patients often complain of a persistent dry cough, fatigue and shortness of breath. The most typical signs of sarcoidosis include: Tender, red bumps on the skin Red and watery eyes Swollen joints Enlarged lymph glands in the neck, armpits and groin Enlarged lymph glands in the chest and lungs   How is sarcoidosis treated? The condition tends to go away by itself, usually within a few months or years. Over-the-counter painkillers can help control any flare-ups. A GP can monitor the condition with regular X-rays, breath and blood tests. Steroid tablets can also help relieve symptoms and prevent inflammation and scarring to organs.   What lifestyle changes can help sarcoidosis? The following measures can help manage the condition: Quitting smoking Avoiding exposure to dust, chemicals, fumes and gases Eating a healthy diet Regular exercise Drinking plenty of water ...

Smoking cessation (quitting)

Smoking is the acute or chronic intoxication produced by addictive tobacco use. It presents all the characteristics of any dependence disorder generated by toxic substances, including the withdrawal syndrome that occurs when they are discontinued; in this case, nicotine. Smoking has a number of health consequences affecting the body in general: pulse and breathing disorders, diarrhoea, vomiting, vertigo, fever, cold extremities, and in very serious cases, collapse and respiratory arrest. Common diseases among smokers are: respiratory, such as laryngitis or bronchitis; Digestive disorders, such as gastritis or heartburn (hyperchlorhydria); Cardiovascular diseases, such as arteriosclerosis; and others such as angina pectoris or lung cancer. There are now numerous smoking cessation programs that include some complementary therapies, such as nicotine replacement therapy in patients with high physical dependence, or antidepressants. Smoking cessation is a therapy to stop smoking. Depending on the attitude of the individual, smoking cessation may include different treatments such as the use of pills. There are three different treatments that have been proven as effective over the years. Nicotine replacement therapy in the form of patches or gum. Bupropion: an antidepressant drug proven effective for smoking cessation. Varenicline: a drug that blocks the effects of nicotine in the nervous system by decreasing the desire to smoke. The treatment is administered for 12 weeks, although in some cases it can be extended. ...

Spirometry

What is spirometry? Spirometry is a test that measures the amount of air you exhale and the speed you exhale it at. It can help to diagnose lung diseases that might otherwise go undetected by other tests. During a spirometry you breathe through a mouthpiece connected to a spirometer, a device that measures the amount and frequency of air inhaled and exhaled during a specific time. The test may be done sitting or standing, but the results of a spirometry may vary. What does a spirometry involve? A spirometry is performed by breathing into a mouthpiece attached to a device called a spirometer. You need to breathe normally and relaxed. However, other medical tests may require you to inhale or exhale strongly after breathing deeply. Why is it performed? This type of medical test can diagnose lung diseases that the specialist is unable to detect in an initial examination. A spirometry is performed: To diagnose some lung diseases such as (asthma, bronchitis and pulmonary emphysema) To identify the reasons for any breathing difficulties To check to see if substances in the workplace might be affecting lung function To check lung function prior to surgery To assess the effect of a drug To assess progress in the treatment of a condition. Preparing for spirometry There are a number of medical recommendations to follow prior to having this medical test. It is advisable not to eat heavy meals before the test and not to smoke for 4 to 6 hours before the test. You will be advised if you need to use a bronchodilator or inhaled medicines before or during the test. What do you feel during the test? During the test you may feel a shortness of breath or feel dizzy. When breathing through the plastic mouthpiece, a nasal clamp is applied to prevent air from escaping through your nose. You must follow the instructions of the specialist and close your lips firmly on the mouthpiece when blowing through it. ...

Thoracic pain

Thoracic pain occurs in the front of the chest and can be a symptom of many conditions: heart disease, such as acute myocardial infarction, coronary insufficiency, or pericarditis; respiratory infections such as influenza, pneumonia; nervous disorders, such as anxiety attacks; or osteoarticular and muscular illnesses. However, the patient must bear in mind that, despite the sensation of severe chest pain, many times the causes are not dangerous to the health of the individual. Since the cause of chest pain can be multiple, to avoid any setbacks, it is essential to consult the specialist promptly to receive immediate treatment, if necessary. ...

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