Cardiopulmonary disease

Cardiopulmonary disease is the medical term used to describe a range of serious disorders that affect the heart (“cardio-”) and lungs (“-pulmonary”). The two primary tobacco-related cardiopulmonary diseases are cardiovascular disease (heart and blood vessel disease) and chronic obstructive pulmonary disorder (COPD).

Cardiovascular disease includes numerous problems, many of which are related to a process called atherosclerosis. Atherosclerosis is a condition that develops when a substance called plaque builds up in the walls of the arteries. This buildup narrows the arteries, making it harder for blood to flow through. If a blood clot forms, it can block the blood flow. This can cause a heart attack or stroke.

Exposure to tobacco smoke has long been recognized as a prominent risk factor for cardiovascular disease. Similarly minimizing exposure to tobacco smoke is the only effective way to prevent COPD. However, the mechanisms by which tobacco toxicants increase the risk of cardiovascular disease and lead to the onset of COPD are still unclear. Despite reductions in smoking over the past decade, cardiovascular disease and COPD (chronic obstructive pulmonary disorder) remain the first and second leading causes of death among smokers. It is important to remember also that for every person who dies because of smoking, at least 30 people live with a serious smoking-related illness.

The emergence of e-cigarettes and other new tobacco products that deliver nicotine aerosolized in various solvents raises new critical questions regarding the potential risk for cardiopulmonary disease among users. The use of these new tobacco products has soared over the last few years, particularly among adolescents, and is expected to overtake the conventional cigarette market within the next decade. These new products deliver nicotine and chemical flavorings aerosolized in a base of propylene glycol and/or glycerin via inhalation. Studies have shown that they produce ultra-fine particulate matter and cytotoxic chemicals, which are known to negatively impact heart and lung function, respectively. Nicotine itself is known to impair lung function, particularly in adolescents. Due to the rapid uptake of these products among young people and the lack of existing regulation of these products, research is critically needed to understand more about the toxicity profile and potential for harm from the use of these products.

Pulmonary disease

Pulmonary diseases also called lung diseases affect tens of millions of people. In the United States, more than 26 million people—including over 6 million children—have asthma, and nearly 16 million people have COPD (chronic obstructive pulmonary disease). Other lung diseases include rare diseases such as pulmonary fibrosis, cystic fibrosis, and lymphangioleiomyomatosis (LAM). Although rare lung diseases affect fewer people, the burden they place on those affected can be significant.

Asthma

Asthma is a chronic disease that affects your airways. Your airways are tubes that carry air in and out of your lungs. If you have asthma, the inside walls of your airways become sore and swollen. That makes them very sensitive, and they may react strongly to things that you are allergic to or find irritating. When your airways react, they get narrower and your lungs get less air.

Symptoms of asthma include

• Wheezing
• Coughing, especially early in the morning or at night
• Chest tightness
• Shortness of breath

Not all people who have asthma have these symptoms. Having these symptoms doesn’t always mean that you have asthma. Your doctor will diagnose asthma based on lung function tests, your medical history, and a physical exam. You may also have allergy tests.

When your asthma symptoms become worse than usual, it’s called an asthma attack. Severe asthma attacks may require emergency care, and they can be fatal.

Asthma is treated with two kinds of medicines: quick-relief medicines to stop asthma symptoms and long-term control medicines to prevent symptoms.

Chronic obstructive pulmonary disease

COPD (chronic obstructive pulmonary disease) makes it hard for you to breathe. The two main types of COPD are chronic bronchitis and emphysema. The main cause of COPD is long-term exposure to substances that irritate and damage the lungs. Most people who have COPD (chronic obstructive pulmonary disease) smoke or used to smoke. However, up to 25 percent of people with COPD never smoked. Long-term exposure to other lung irritants—such as air pollution, chemical fumes, or dusts—also may contribute to COPD. A rare genetic condition called alpha-1 antitrypsin deficiency can also cause COPD.

In the United States, the term COPD includes two main conditions, emphysema and chronic bronchitis. In emphysema, the walls between many of the air sacs are damaged. As a result, the air sacs lose their shape and become floppy. This damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones. If this happens, the amount of gas exchange in the lungs is reduced.

In chronic bronchitis, the lining of the airways stays constantly irritated and inflamed, and this causes the lining to swell. Lots of thick mucus forms in the airways, making it hard to breathe.

Most people who have COPD have both emphysema and chronic bronchitis, but the severity of each condition varies from person to person. Thus, the general term COPD is more accurate.

COPD is a major cause of disability, and it is the fourth leading cause of death in the United States. Currently, 16 million people are diagnosed with COPD. Many more people may have the disease and not even know it.

At first, COPD may cause no symptoms or only mild symptoms. As the disease gets worse, symptoms usually become more severe. They include

• A cough that produces a lot of mucus
• Shortness of breath, especially with physical activity
• Wheezing
• Chest tightness

Symptoms often worsen over time and can limit your ability to do routine activities. Severe COPD may prevent you from doing even basic activities like walking, cooking, or taking care of yourself.

Most of the time, COPD is diagnosed in middle-aged or older adults. COPD is not contagious, meaning it cannot be passed from person to person.

Doctors use lung function tests, imaging tests, and blood tests to diagnose COPD. COPD has no cure yet, and doctors do not know how to reverse the damage to the lungs. Treatments may relieve symptoms. They include medicines, oxygen therapy, surgery, or a lung transplant. Quitting smoking is the most important step you can take to treat COPD.

Cardiovascular disease

Cardiovascular disease can refer to a number of conditions:

Heart attack

A heart attack occurs when the blood flow to a part of the heart is blocked by a blood clot. If this clot cuts off the blood flow completely, the part of the heart muscle supplied by that artery begins to die.

Most people survive their first heart attack and return to their normal lives, enjoying many more years of productive activity. But experiencing a heart attack does mean that you need to make some changes.

The medications and lifestyle changes that your doctor recommends may vary according to how badly your heart was damaged, and to what degree of heart disease caused the heart attack.

Stroke

An ischemic stroke (the most common type of stroke) occurs when a blood vessel that feeds the brain gets blocked, usually from a blood clot.

When the blood supply to a part of the brain is cut off, some brain cells will begin to die. This can result in the loss of functions controlled by that part of the brain, such as walking or talking.

A hemorrhagic stroke occurs when a blood vessel within the brain bursts. This is most often caused by uncontrolled hypertension (high blood pressure).

Some effects of stroke are permanent if too many brain cells die after being starved of oxygen. These cells are never replaced.

The good news is that sometimes brain cells don’t die during stroke — instead, the damage is temporary. Over time, as injured cells repair themselves, previously impaired function improves. (In other cases, undamaged brain cells nearby may take over for the areas of the brain that were injured.)

Either way, strength may return, speech may get better and memory may improve. This recovery process is what stroke rehabilitation is all about.

Heart failure

Heart failure, sometimes called congestive heart failure, means the heart isn’t pumping blood as well as it should. Heart failure does not mean that the heart stops beating — that’s a common misperception. Instead, the heart keeps working, but the body’s need for blood and oxygen isn’t being met.

Heart failure can get worse if left untreated. If your loved one has heart failure, it’s very important to follow the doctor’s orders.

Arrhythmia

Arrhythmia refers to an abnormal heart rhythm. There are various types of arrhythmias. The heart can beat too slow, too fast or irregularly.

Bradycardia, or a heart rate that’s too slow, is when the heart rate is less than 60 beats per minute. Tachycardia, or a heart rate that’s too fast, refers to a heart rate of more than 100 beats per minute.

An arrhythmia can affect how well your heart works. With an irregular heartbeat, your heart may not be able to pump enough blood to meet your body’s needs.

Heart valve problems

When heart valves don’t open enough to allow the blood to flow through as it should, a condition called stenosis results. When the heart valves don’t close properly and thus allow blood to leak through, it’s called regurgitation. If the valve leaflets bulge or prolapse back into the upper chamber, it’s a condition called prolapse.

Cardiopulmonary rehabilitation

Cardiopulmonary rehabilitation is a broad program that helps improve the well-being of people who have heart and chronic breathing problems. Cardiac rehabilitation may benefit those who have experienced a recent heart attack or cardiac surgery, as well as other heart-related health problems. Pulmonary rehabilitation may be beneficial to individuals with asthma, chronic bronchitis, chronic obstructive pulmonary disease (COPD), emphysema, cystic fibrosis, scoliosis or other lung conditions. Your doctor may also recommend pulmonary rehabilitation before and after surgery for a lung transplant or lung cancer.

Cardiopulmonary rehabilitation may include an exercise program, disease management training, and nutritional and psychological counseling. The program’s goal is to help you stay active and carry out your daily activities.

Your rehab team may include doctors, nurses, physical therapists, respiratory therapists, exercise specialists, and dietitians. These health professionals will create a program that meets your needs.