Emphysema

What is emphysema?

Emphysema is a type of COPD (chronic obstructive pulmonary disease). COPD is a group of lung diseases that make it hard to breathe and get worse over time. The other main type of COPD is chronic bronchitis. Most people with COPD have both emphysema and chronic bronchitis, but how severe each type is can be different from person to person.

Emphysema affects the air sacs in your lungs. Normally, these sacs are elastic or stretchy. When you breathe in, each air sac fills up with air, like a small balloon. When you breathe out, the air sacs deflate, and the air goes out.

In emphysema, the walls between many of the air sacs in the lungs are damaged. This causes the air sacs to lose their shape and become floppy. The damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones. This makes it harder for your lungs to move oxygen in and carbon dioxide out of your body.

What causes emphysema?

The cause of emphysema is usually long-term exposure to irritants that damage your lungs and the airways. In the United States, cigarette smoke is the main cause. Pipe, cigar, and other types of tobacco smoke can also cause emphysema, especially if you inhale them.

Exposure to other inhaled irritants can contribute to emphysema. These include secondhand smoke, air pollution, and chemical fumes or dusts from the environment or workplace.

Rarely, a genetic condition called alpha-1 antitrypsin deficiency can play a role in causing emphysema.

Who is at risk for emphysema?

The risk factors for emphysema include:

• Smoking. This the main risk factor. Up to 75% of people who have emphysema smoke or used to smoke.
• Long-term exposure to other lung irritants, such as secondhand smoke, air pollution, and chemical fumes and dusts from the environment or workplace.
• Age. Most people who have emphysema are at least 40 years old when their symptoms begin.
• Genetics. This includes alpha-1 antitrypsin deficiency, which is a genetic condition. Also, smokers who get emphysema are more likely to get it if they have a family history of COPD.

What are the symptoms of emphysema?

At first, you may have no symptoms or only mild symptoms. As the disease gets worse, your symptoms usually become more severe. They can include:

• Frequent coughing or wheezing
• A cough that produces a lot mucus
• Shortness of breath, especially with physical activity
• A whistling or squeaky sound when you breathe
• Tightness in your chest

Some people with emphysema get frequent respiratory infections such as colds and the flu. In severe cases, emphysema can cause weight loss, weakness in your lower muscles, and swelling in your ankles, feet, or legs.

How is emphysema diagnosed?

Your health care provider may use many tools to make a diagnosis:

• A medical history, which includes asking about your symptoms
• A family history
• Other tests tests, such as lung function tests, a chest x-ray or CT scan, and blood tests

What are the treatments for emphysema?

There is no cure for emphysema. However, treatments can help with symptoms, slow the progress of the disease, and improve your ability to stay active. There are also treatments to prevent or treat complications of the disease. Treatments include:

• Lifestyle changes, such as
  • Quitting smoking if you are a smoker. This is the most important step you can take to treat emphysema.
  • Avoiding secondhand smoke and places where you might breathe in other lung irritants
  • Ask your health care provider for an eating plan that will meet your nutritional needs. Also ask about how much physical activity you can do. Physical activity can strengthen the muscles that help you breathe and improve your overall wellness.
• Medicines, such as
  • Bronchodilators, which relax the muscles around your airways. This helps open your airways and makes breathing easier. Most bronchodilators are taken through an inhaler. In more severe cases, the inhaler may also contain steroids to reduce inflammation.
  • Vaccines for the flu and pneumococcal pneumonia, since people with emphysema are at higher risk for serious problems from these diseases
  • Antibiotics if you get a bacterial or viral lung infection
• Oxygen therapy, if you have severe emphysema and low levels of oxygen in your blood. Oxygen therapy can help you breathe better. You may need extra oxygen all the time or only at certain times.
• Pulmonary rehabilitation, which is a program that helps improve the well-being of people who have chronic breathing problems. It may include
  • An exercise program
  • Disease management training
  • Nutritional counseling
  • Psychological counseling
• Surgery, usually as a last resort for people who have severe symptoms that have not gotten better with medicines. There are surgeries to
  • Remove damaged lung tissue
  • Remove large air spaces (bullae) that can form when air sacs are destroyed. The bullae can interfere with breathing.
  • Do a lung transplant. This is might be an option if you have very severe emphysema.

If you have emphysema, it's important to know when and where to get help for your symptoms. You should get emergency care if you have severe symptoms, such as trouble catching your breath or talking. Call your health care provider if your symptoms are getting worse or if you have signs of an infection, such as a fever.

Can emphysema be prevented?

Since smoking causes most cases of emphysema, the best way to prevent it is to not smoke. It's also important to try to avoid lung irritants such as secondhand smoke, air pollution, chemical fumes, and dusts.

NIH: National Heart, Lung, and Blood Institute

Heart Diseases

What is heart disease?

Heart disease is a general term that includes many types of heart problems. It's also called cardiovascular disease, which means heart and blood vessel disease.

Heart disease is the leading cause of death in the United States, but there are ways to prevent and manage many types of heart disease.

What are the types of heart disease?

There are many different types of heart disease. Some you may be born with, called congenital heart disease. Other types develop during your lifetime.

Coronary artery disease (also called coronary heart disease) is the most common type of heart disease. It happens slowly over time when a sticky substance called plaque builds up in the arteries that supply your heart muscle with blood. The plaque narrows or blocks blood flow to the heart muscle and can lead to other heart problems:

• Angina - chest pain from lack of blood flow
• Heart attacks - when part of the heart muscle dies from loss of blood flow
• Heart failure - when your heart can't pump enough blood to meet your body's needs
• Arrhythmia - a problem with the rate or rhythm of your heartbeat

Other types of heart diseases may affect your heart valves or heart muscle (cardiomyopathy).

What causes heart diseases?

The causes of heart disease depend on the type of disease. Some possible causes include lifestyle, genetics, infections, medicines, and other diseases.

Who is more likely to develop heart diseases?

There are many different factors that can make you more likely to develop heart disease. Some of these factors you can change, but others you cannot.

• Age. Your risk of heart disease goes up as you get older.
• Sex. Some factors may affect heart disease risk differently in women than in men.
• Family history and genetics. A family history of early heart disease raises your risk of heart disease. And research has shown that some genes are linked to a higher risk of certain heart diseases.
• Race/ethnicity. Certain groups have higher risks than others.
• Lifestyle habits. Over time, unhealthy lifestyle habits can raise your risk heart disease:
  • Eating a diet high in saturated fats, refined carbohydrates, and salt.
  • Not getting enough physical activity.
  • Drinking too much alcohol.
  • Smoking and exposure to secondhand smoke.
  • Too much stress.
• Having other medical conditions can raise your risk of heart diseases. These conditions include:
  • High blood pressure.
  • High cholesterol levels.
  • Diabetes.
  • Obesity.
  • Autoimmune and inflammatory diseases.
  • Chronic kidney disease.
  • Metabolic syndrome.

What are the symptoms of heart disease?

Your symptoms will depend on the type of heart disease you have. You may not have symptoms at first. In some cases, you may not know you have heart disease until you have a complication such as a heart attack.

How are heart diseases diagnosed?

To find out if you have heart disease, your health care provider will:

• Ask about your medical history, including your symptoms
• Ask about your family health history, including relatives who have had heart disease
• Do a physical exam
• Likely run heart tests and blood tests

In some cases, your provider may refer you to a cardiologist (a doctor who specializes in heart diseases) for tests, diagnosis, and care.

What are the treatments for heart disease?

Treatment plans for heart disease depend on the type of heart disease you have, how serious your symptoms are, and what other health conditions you have. Possible treatments may include:

• Heart-healthy lifestyle changes
• Medicines
• Procedures or surgeries
• Cardiac rehabilitation

Can heart diseases be prevented?

You may be able to lower your risk of certain heart diseases by making heart-healthy lifestyle changes and managing any other medical conditions you have.

NIH: National Heart, Lung, and Blood Institute

HIV and Infections

Having HIV/AIDS weakens your body's immune system. It destroys the white blood cells that fight infection. This puts you at risk for opportunistic infections (OIs). OIs are serious infections that take advantage of your weak immune system. These infections are less common and less severe in healthy people.

There are many types of OIs:

• Bacterial infections, including tuberculosis and a serious related disease, Mycobacterium avium complex (MAC)
• Viral infections, such as cytomegalovirus (CMV) and hepatitis C
• Fungal infections, like yeast infections, cryptococcal meningitis, pneumocystis carinii pneumonia (PCP) and histoplasmosis
• Parasitic infections, such as crypto (cryptosporidiosis) and toxo (toxoplasmosis)

Having HIV/AIDS can make infections harder to treat. People with HIV/AIDS are also more likely to have complications from common illnesses such as the flu.

You can help prevent infections by taking your HIV/AIDS medicines. Other things that can help include practicing safe sex, washing your hands well and often, and cooking your food thoroughly.

Rotavirus Infections

Rotavirus is a virus that causes gastroenteritis. Symptoms include severe diarrhea, vomiting, fever, and dehydration. Almost all children in the U.S. are likely to be infected with rotavirus before their 5th birthday.

Infections happen most often in the winter and spring. It is very easy for children with the virus to spread it to other children and sometimes to adults. Once a child gets the virus, it takes about two days to become sick. Vomiting and diarrhea may last from three to eight days.

There is no medicine to treat it. To prevent dehydration, have your child drink plenty of liquids. Your health care provider may recommend oral rehydration drinks. Some children need to go to the hospital for IV fluids. Two vaccines against rotavirus infections are available.

Centers for Disease Control and Prevention

Staphylococcal Infections

What are Staphylococcal (staph) infections?

Staphylococcus (staph) is a group of bacteria. There are more than 30 types. A type called Staphylococcus aureus causes most infections.

Staph bacteria can cause many different types of infections, including:

• Skin infections, which are the most common types of staph infections.
• Bacteremia, an infection of the bloodstream. This can lead to sepsis, a very serious immune response to infection.
• Bone infections.
• Endocarditis, an infection of the inner lining of the heart chambers and valves.
• Food poisoning.
• Pneumonia.
• Toxic shock syndrome (TSS), a life-threatening condition caused by toxins from certain types of bacteria.

What causes staph infections?

Some people carry staph bacteria on their skin or in their noses, but they do not get an infection. But if they get a cut or wound, the bacteria can enter the body and cause an infection.

Staph bacteria can spread from person to person. They can also spread on objects, such as towels, clothing, door handles, athletic equipment, and remotes. If you have staph and do not handle food properly when you are preparing it, you can also spread staph to others.

Who is more likely to get a staph infection?

Anyone can develop a staph infection, but certain people are more likely to get one, including those who:

• Have a chronic condition such as diabetes, cancer, vascular disease, eczema, and lung disease
• Have a weakened immune system, such as from HIV, medicines to prevent organ rejection, or chemotherapy
• Had surgery
• Are in the hospital
• Use a catheter, breathing tube, or feeding tube
• Have an implanted device, such as a pacemaker or artificial joint or heart valve
• Have burns, especially if they are deep or cover a large area of the body
• Are on dialysis
• Inject illegal drugs
• Do contact sports, since you may have skin-to-skin contact with others or share equipment

What are the symptoms of staph infections?

The symptoms of a staph infection depend on the type of infection:

• Skin infections can look like pimples or boils. They may be red, swollen, and painful. Sometimes there is pus or other drainage. They can turn into impetigo, which turns into a crust on the skin, or cellulitis, a swollen, red area of skin that feels hot.
• Bone infections can cause pain, swelling, warmth, and redness in the infected area. You may also have chills and a fever.
• Endocarditis causes some flu-like symptoms: fever, chills, and fatigue. It also causes symptoms such as rapid heartbeat, shortness of breath, and fluid buildup in your arms or legs.
• Food poisoning typically causes nausea and vomiting, diarrhea, and fever. If you lose too many fluids, you may also become dehydrated.
• Pneumonia symptoms include a high fever, chills, and cough that doesn't get better. You may also have chest pain and shortness of breath.
• Toxic shock syndrome (TSS) causes high fever, sudden low blood pressure, vomiting, diarrhea, and confusion. You may have a sunburn-like rash somewhere on your body. TSS can lead to organ failure.

How are staph infections diagnosed?

Your health care provider will do a physical exam and ask about your symptoms. Often, providers can tell if you have a staph skin infection by looking at it. To check for other types of staph infections, providers may do a culture, with a skin scraping, tissue sample, stool sample, or throat or nasal swabs. There may be other tests, such as imaging tests, depending on the type of infection.

What are the treatments for staph infections?

Treatment for staph infections is antibiotics. Depending on the type of infection, the antibiotics might be a cream, ointment, medicines (to swallow), or intravenous (IV) medicine. If you have an infected wound, your provider might drain it. Sometimes you may need surgery for bone infections.

Some staph infections, such as MRSA (methicillin-resistant Staphylococcus aureus), are resistant to many antibiotics. There are still certain antibiotics that can treat these infections.

Can staph infections be prevented?

Certain steps can help to prevent staph infections:

• Use good hygiene, including washing your hands often.
• Don't share towels, sheets, or clothing with someone who has a staph infection.
• It's best not to share athletic equipment. If you do need to share, make sure that it is properly cleaned and dried before you use it.
• Practice food safety, including not preparing food for others when you have a staph infection.
• If you have a cut or wound, keep it covered.