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- Chronic Bronchitis is a form of Chronic Obstructive Pulmonary Disease (COPD). The other form is called Emphysema (see that
section).
- Chronic Bronchitis is defined
as a cough productive of mucous for 3 months (or more) of
the year, for two years in a row (without another disease
present that could cause the same symptoms).
- Most patients with COPD do not strictly have either Emphysema or chronic Bronchitis, but often have features of both. Additionally, chronic Bronchitis can be complicated by right Heart Failure (cor
pulmonale). The reason this occurs is that the lungs are
damaged, and the right side of the heart has to work much
harder to pump blood through the
lungs.
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- Productive cough (as described
above)
- Shortness of
breath
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- Cigarette smoking
- Air pollution
- Occupational exposures (e.g.,
noxious gas)
- Chronic allergies
- Possible genetic
factors
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- Jugular venous distention may be
present
- Lung exam may be abnormal, showing
rhonchi and wheezes
- Heart exam may reveal early
diastolic gallop and holosystolic murmur in tricuspid area
- Skin color may be bluish
(cyanotic)
- May have leg swelling
(edema)
- Sputum cultures usually grow
Streptococcus pneumoniae, Haemophilus influenzae, or
Moxarella catarrhalis
- Arterial blood gas shows decreased
pO2 and increased pCO2
- Complete blood count
may reveal increased red blood cells and
hemoglobin/hematocrit (the reason is that the body tries to
compensate for lower oxygen levels by increasing the number
of red blood cells)
- Chest X-Ray may be normal or show
"tramline" shadows and increased bronchovascular markings.
The cardiac silhouette (right side) may
enlarge.
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- Quit Smoking using an
effective method (e.g., Zyban, Nicotine patches, etc.)
- Supplement oxygen if p02 is less
than 55 (normally, it is about 90)
- Supplement oxygen if p02 is less than or equal to 60 and cor pulmonale (right Heart Failure) is
present
- Proper diet and a specially designed
exercise (usually walking) programs may help symptoms.
- Bronchopulmonary drainage techniques
(e.g., posterior percussion and drainage) as needed
- Pneumonia vaccine (Pneumovax) should
be given approximately every seven years.
- Yearly influenza vaccine
- Consider Haemiphilus vaccine in
those not immunized
- Phlebotomy for erythrocytosis
usually only if hematocrit is greater than 55, and the
patient is symptomatic (e.g., headaches). Other causes of
erthrocytosis may involve phlebotomy at much lower levels
(e.g., hemochromatosis)
- Lung transplant may be considered in
severe cases
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