2. •“A disease state characterized by airflow limitation that
is not fully reversible”
By, Global Initiative for Chronic Obstructive Lung Disease (GOLD)
•“ COPD is defined as a preventable and treatable lung disease
with some significant extrapulmonary effects that may
contribute to the severity in individual patient .”
Davidson’s Principles and Practice of Medicine
COPD Presentation – By Dr. Ankita Bali 2
3. -Emphysema- an anatomically defined condition characterized by
destruction and enlargement of the lung alveoli;
-Chronic bronchitis- a clinically defined condition with chronic cough and
Phlegm
-Small airways disease- a condition in which small bronchioles are narrowed.
(Asthma and Bronchiactsis is included in this category )
COPD is present only if chronic airflow obstruction occurs;
Chronic bronchitis without chronic airflow obstruction is not included within COPD
(Classification from – Harrison’s
Principles of Internal Medicine.)
COPD Presentation – By Dr. Ankita Bali 3
5. 80- 90 % COPD’s Death are
caused by Smoking.
•Cigarette Smoking
•Airway Hyper-responsiveness
•Recurrent Respiratory Infections
•Occupational Exposures to Pollutants.
•Ambient Air Pollution
•Passive or second hand smoking
experience
•Genetic Considerations (Severe antitrypsin
(AT) deficiency is a proven genetic risk factor
for COPD; there is increasing evidence that
other genetic determinants also exist.)
(From– Harrison’s Principle of Internal Medicine)
COPD Presentation - By Dr. Ankita Bali 5
8. Gold
Stage
Severity Symptoms Spirometry
0 At Risk Chronic cough, sputum
production
Normal
I Mild With or without chronic
cough or sputum production
FEV1/FVC <0.7 and FEV1 80% predicted
IIA Moderate With or without chronic
cough or sputum production
FEV1/FVC <0.7 and 50% FEV1 <80%
predicted
III Severe With or without chronic
cough or sputum production
FEV1/FVC <0.7 and 30% FEV1 <50%
predicted
IV Very Severe With or without chronic
cough or sputum production
FEV1/FVC <0.7 and FEV1 <30% predicted
or
FEV1 <50% predicted with respiratory
failure or signs of right heart failure
(From– Harrison’s Principle of Internal Medicine)
COPD Presentation - By Dr. Ankita Bali
8
9. COPD Presentation - By Dr. Ankita Bali 9
History
-The three most common symptoms in COPD :
-Cough,
-Sputum production, and
-Exertional dyspnea.
(Many patients have such symptoms for months
or years before seeking medical attention.)
-ONSET
Gradual (commonly )or acute .
-The development of Exertional dyspnea
( As the dieases progresses dyspnoea even on rest.
- Resting hypoxemia in later stages which wil require institution of supplemental oxygen
(From– Harrison’s Principle of Internal Medicine)
10. COPD Presentation - By Dr. Ankita Bali 10
Defination - Chronic Bronchitis is defined as a disease characterised by cough and
sputum for at least 3 consecutive months in a year for more than 2 successive years.
(Ref. – API Textbook of Medicine )
Clinical Features
•Repeated attack of productive cough.
•Shortness of breath.
•Respiration Rate hurried
•Raised temperature
•Central Cynosis maybe present
Investigations –
•Blood count – Polycythemia in long
standing cases
•Pulmonary Function Test
•E.C.G – May show right ventricular hypertrophy,
• supraventricular and ventricular arrhythmia
•Bacterial Culture of sputum
(From – API Textbook of Medicine)
11. COPD Presentation - By Dr. Ankita Bali 11
Defination – It is a condition of abnormal permanent enlargement of air spaces distal to
Terminal bronchioles with destruction of their wall without obvious fibrosis.
“Emphysema may be defined by the pattern of the enlarged spaces: Centriacinar ,
Panacinar and periacinar.” – Principles and Practice of Medicine by Davidson
Clinical Features
•Usually above 40 years
•Males>Females
•Breathlessness and hurried respiration
•Wheezing sound
•Gradual weakness and loss of weight
•Clubbing of finger and central cynosis
•Barrel shaped chest
•Vocal fermitus diminished ;liver , spleen and cardiac dullness ; Breath sounds diminished.
Investigations
-X- ray of chest
-Lung Function Test
12. COPD Presentation – By Dr. Ankita Bali 12
(Reference from – www.pinterest.com )
15. COPD Presentation – By Dr. Ankita Bali 15
(From- www.clinicalresearchcentre.com and www.patients.thoracic.org )
Emphysema Chronic Bronchitis Bronchial Asthma
16. COPD Presentation - By Dr. Ankita Bali 16
•Smoking cessation
•Improve quality of
life
•Inhalers
(Bronchodilators)
•Oxygen therapy
•Homoepathic Treatment
Image from – www.chestnet.org
17. COPD Presentation - By Dr. Ankita Bali 17
Emphsema –
Amm. Carb
Ant. Ars.
Lobel.
Chronic Bronchitis -
Ammonniac
Ars.
Seneg
Sulph
Antim jod
Bronchial Asthma -
Ipec.
Ars.
Eucalypt
Adrenalin
Natrum Sulph
(From– Pocket Manual and Homoeopathic Materia Medica and Repertory by William Boericke)
18. COPD Presentation – By Dr. Ankita Bali 18
•Content-
Harrison’s Principle of Internal Medicine
Davidson’s Principles and Practice of Medicine
www.antidotecme.com
•Homoeopathic Therapeutics
Pocket Manual and Homoeopathic Materia Medica
and Repertory by William Boericke
•Images –
www.hickesvilleschools.org
www.sphweb.bumc.bu.edu
www.clinicalresearchcentre.com
www.medcomic.com
www.patients.thoracic.org
www.chestnet.org
www.pinterest.com