This article looks at pulmonary conditions, their diagnosis, and their treatment.

What Are Some Pulmonary Problems?

There are many conditions that are classified as pulmonary in nature. Some of the major ones include:

Asthma: Asthma is one of the two most common chronic pulmonary diseases. It affects around 260 million people worldwide. People with asthma have attacks of breathlessness, which may occur frequently and in the presence of certain triggers.    Acute and chronic bronchitis: Bronchitis is a condition in which your airways become irritated and inflamed. Acute bronchitis is usually caused by a viral infection and typically resolves on its own. Chronic bronchitis is a lifelong condition caused by long-term exposure to irritants like cigarette smoke or air pollution. Bronchiectasis: People with this condition have abnormally wide airways that fill with mucus. This can cause a persistent cough and increase the risk of infections such as pneumonia.  Causes of bronchiectasis include previous lung infections like whooping cough or pneumonia, problems with the immune system, and cystic fibrosis. Chronic obstructive lung disease (COPD): This includes chronic obstructive bronchitis and emphysema. It is often due to cigarette smoke and some occupational exposures. The symptoms are a cough and shortness of breath developing over several years. Lung cancer: While smoking is a leading cause, exposure to asbestos or radon can also increase the risk, and cancer from other parts of the body can metastasize to the lungs. Pneumonia: Infection and inflammation of the lungs can develop from an upper respiratory tract infection or influenza. It can be caused by a virus or a bacteria. Pulmonary embolism: This is a blood clot in the lungs and is a medical emergency. Pulmonary hypertension: This is high blood pressure affecting the arteries in your lungs, which makes the right side of your heart work harder, eventually causing it to fail. Sarcoidosis: This is a rare disease where tiny lumps of cells (granulomas) form in the lungs as well as other organs, affecting how they work. Sleep apnea: This is a group of disorders that affect the ability to breathe while sleeping.

Pulmonary Function Tests

Pulmonary function tests (PFT) are performed to determine if an individual is experiencing problems with their lungs. These tests measure:

AirflowThe volume of your lungsHow well your lungs exchange gasHow you respond to bronchodilators (medications that open the airways)How your respiratory muscles function

PFTs require you to blow into a small device called a spirometer and also may use a pulse oximeter attached to a finger. They can usually be performed in a clinic setting.

For some tests, you will have your normal breathing measured. For others, you may be required to exhale forcefully, or to attempt to empty your lungs of air. You may be given an inhaled medication after these tests, then perform the tests again to determine if the medication was effective.

If you already take breathing medications, you may be asked to skip your dose prior to having these tests to determine your baseline lung function.

Exercise testing is also done to test your lung function. This can include a six-minute walk test or cardiopulmonary exercise testing (CPET) done on a treadmill or exercise bike to get data on oxygen consumption, carbon dioxide production, and heart rate.

Who Treats Pulmonary Issues?

Pulmonary disease is often treated by a pulmonologist, a specialist in the treatment of lung and breathing issues ranging from asthma to chronic obstructive pulmonary disease to lung cancer. Pulmonologists do not perform lung surgeries, but they may perform lung procedures, such as a bronchoscopy, a procedure that allows a medical professional to visualize the inside of the lungs.

If surgery is needed, pulmonary problems are typically addressed by a cardiothoracic surgeon. This is a specialist who is trained in performing surgeries on the lungs as well as the heart, esophagus, and other chest organs.

Other conditions that are acute, such as a pulmonary embolism, may be treated by hospitalists, intensivists, or other physicians.

Summary

In medicine, “pulmonary” refers to conditions of the lungs. Some common pulmonary conditions include asthma, bronchitis, pneumonia, and sleep apnea. 

Pulmonary conditions are usually diagnosed with pulmonary function tests. These tests measure airflow, lung volume, muscle function, and how well your lungs take in oxygen and breathe out carbon dioxide.

Pulmonary conditions are usually treated by a pulmonologist. Sugery on the lungs is usually performed by a cardiotoracic surgeon.