Pulmonary Function Tests or PFTs are a set of tests that are used to determine, measure or observe the functioning of the lungs. The most common pulmonary function tests used are spirometry, gas diffusion, and lung plethysmography. 

Highlights of pulmonary function tests

A spirometry test is used to measure the amount of air inhaled and exhaled. It also measures the amount of time taken to complete a respiration cycle.
A lung plethysmography measures the amount of air in the lungs after the patient has taken a deep breath. It also measures the amount of air that remains in the lungs after the patient has exhaled as much air as possible.
What does a Pulmonary Function Test measure?
Pulmonary function tests would not only check how well the person is breathing but also how effectively the lungs are able to conduct oxygen to the rest of the body. In addition to air flow, these tests would measure the size and volume of the lung and lung diffusion.

These tests can also be used to measure

Total Lung Capacity   the amount of air present in the lungs after breathing in deeply
Forced Vital Capacity   the amount of air that can be exhaled after breathing in deeply
Minute Volume   the amount of air exhaled per minute
Vital Capacity   the total volume of air that can be breathed out after inhaling as much as possible
Tidal Volume   the amount of air inhaled or exhaled when breathing normally
Maximum voluntary ventilation   the amount of air that can be inhaled and exhaled in one minute
Functional Residual Capacity   the amount of air that remains in the lungs when breathing normally
Forced Expiratory Flow   the flow or volume of air during an exhalation
Peak Expiratory Flow Rate   the rate at which a person can exhale
When are Pulmonary Function Tests recommended?
A physician might recommend a patient undergo a PFT as part of a routine physical check-up. This test would be advised if the patient is experiencing any symptoms associated with lung problems or disorders such as asthma, respiratory infections, chronic obstructive pulmonary disease, COPD. A doctor would also use these tests to monitor and check whether a certain treatment prescribed for a lung disease or condition is working effectively.

Pulmonary function tests are safe as they are non-invasive but it is important to follow the instructions of the doctor or technician before, after and during the test. It is important to make your doctor aware of any surgeries, respiratory infections, chest pains or heart attacks that you might have experienced before the test. If you are taking any medications you might need to follow the advice of the doctor as to whether you can take them before the test.

Your doctor would also advice you on how to prepare for the test such as not eating a large meal, avoiding caffeine and wearing loose-fitting clothes. If you have any doubts, concerns or queries discuss them with your doctor.

Pulmonary Function Tests - Why Is It Required?

The Interstitium is a network of tissues in the lungs. It supports the functioning of microscopic air sacs in the lungs, known as Alveoli. Tiny blood vessels travelling through the interstitium help in exchange of gases between blood and air. In ILD or Interstitial lung disease, this important function of the lungs is disturbed. This can lead to ILD, including Sarcoidosis.

In general, the symptoms of ILD include shortness of breath, dry and non-productive cough and unexplained weight loss.

Causes Of Interstitial Lung Disease

It is estimated that regular exposure to irritants through inhalation, at work or otherwise, can precipitate ILD. Bacteria, Viruses, and Fungi are known to cause Interstitial Pneumonias. The following irritants can cause ILD:

  Silica dust
  Asbestos
  Coal dust and other dusts, such as those inhaled during working in mines
  Talc
  Bird proteins (such as Chicken or Pigeon food)
  Grain dust inhaled from farming

Drugs such as Amiodarone, Nitrofurantoin, Bleomycin etc. may also cause Interstitial Lung Disease. However, a fair chunk of the causes of Interstitial Lung Disease are unknown.



About Sarcoidosis

In Sarcoidosis, there is growth of tiny inflammatory cells in different organs of the body, such as the Lymph nodes, Skin, Eyes and the Lungs. Lungs are the most common organs which Sarcoidosis affects.

Symptoms of ILD and Sarcoidosis

  Symptoms may include Fever, Fatigue, Shortness of breath, Weight loss, Persistent cough, Swollen lymph nodes, Chest pain, Wheezing etc.
  There may be reddish-purple bumps on shins or ankles, sores on nose, ears and cheeks, growth of nodules under the skin, etc.
  The patient may have Blurred vision, Eye pain, Severe redness and Sensitivity to light.
  A patient may also suffer from Chest pain, Shortness of breath, Fainting, fatigue, Irregular heartbeats, Palpitations, Swelling due to Accumulation of Fluid, etc.

Treatment of ILD and Sarcoidosis

  Antibiotics for Interstitial Pneumonia condition
  Corticosteroids or Immunosuppressants for skewed immune response
  Oxygen inhalation for low oxygen level in body due to ILD
  Antioxidants to reduce the rate of decline in lung function.

Sarcoidosis

  Though there is no cure for this disease, a patient may be treated through medicine if the disease starts affecting the functioning of other organs.
  The patient may be given Corticosteroids to Suppress Inflammation.
  If the condition is worse, the patient may also be given Immunosuppressants and other medicines to overcome specific organic problems.

ILD and Sarcoidosis are common diseases nowadays due to increasing pollution all around. In case of any of the symptoms of ILD and Sarcoidosis show up in a patient, it is highly recommended to get advice from an experienced Pulmonologist. The treatment is mostly antibiotic-based, and curbs the infection out of the body. The sooner the treatment can start, the better it is.

ILD And Sarcoidosis - Causes, Symptom And Treatment Of Them!

When blood clot blocks one or more arteries in your lungs the condition is known as pulmonary embolism. It can cause a decrease in the oxygen levels in your blood, damage to your lungs due to sudden restrictions in the flow of blood along with adverse effects on other parts of your body. Life threatening blockage can cause death if left untreated and you should immediately contact your health care provider to get proper diagnosis. Pulmonary embolism requires various lab tests and generally requires short time to resolve.

Symptoms:
The symptoms of pulmonary embolism mainly depend upon many factors pertaining to your previous medical history. Pulmonary embolism varies with the size of your lungs, the size of the clots formed in your blood, and any other underlying history of the heart or lungs. That said, pulmonary embolism has symptoms which are not similar to any two persons and will vary accordingly.

The common symptoms however may include the following and you are advised to opt for a health checkup if these are persistent in your body:
1. Cough along with bloody sputum is a common symptom.
2. Shortness of breath, which will become worse as the days passes by. They will appear suddenly and cause huge discomfort in breathing.
3. Chest pain which may give you the feeling of a heart attack. The pain will intensify when you sit to eat or cough. Deep breath will cause problems too and will not go away easily with exertion.
4. Some other symptoms include fever, excess sweat, irregular heartbeat and dizziness.

Pulmonary embolism can be diagnosed by the following methods:
1. Electrocardiography (also known popularly as ECG) to measure your heart's electrical activity and functioning.
2. CT plumonary angiography is gold standard for diagnosing pulmonary embolism.
3. Chest x ray, which is a common and non invasive test to check your heart and lungs as well as the problems with any bones surrounding them.
4. ECHO can detect secondary changes in heart due to pulmonary embolism.

Treatment of pulmonary embolism can be done with medicines if it is detected at an early stage or also if the clot is small. However, if the size of your clot is problematic and blocks the blood flow to your lungs or heart then surgery may be necessary. Open surgery and clot removal surgery are common in the treatment of pulmonary embolism and will require good regular follow up check ups. Regular leg exercises will also reduce the chances of any underlying disease and you should hence consult your doctor.

What Is Pulmonary Embolism?

When you suffer from dry, chronic cough along with shortness of breath, it is normal to get worried and annoyed. You will want to know the cause and the cure. Note that it might be due to a condition called the interstitial lung disease.

Including almost more than 200 different lung conditions, interstitial lung disease refers to the inflammation and scarring caused in the lungs, which leads to less oxygen entering the blood. Mainly affecting the interstitial part of the anatomic structure of the lungs, which is responsible for the oxygen flow into the blood, interstitial lung disease can damage other parts of the lungs too, such as the lung lining, the airways or the blood vessels. The following is a brief account of the types, causes, symptoms, and treatment of ILD.

Types
Interstitial lung disease can be of various kinds, though all of them leads to the thickening of the lung s interstitial part. Some of the types of ILD are 

Nonspecific interstitial pneumonitis
Idiopathic pulmonary fibrosis
Acute interstitial pneumonitis
 Hypersensitivity pneumonitis
Asbestosis
Sarcoidosis
Cryptogenic organizing pneumonia or COP, etc. 
While some of the ILD types are short lived, some are irreversible and chronic.

The primary causes of interstitial lung disease are viruses, fungi, and bacteria. Regular exposure to inhalable irritants such as talc, silica dust, asbestos, coal dust or any other kind of metal dust, bird proteins of pigeons, chickens or any exotic birds, grain dust, etc. can also cause interstitial lung disease. Though rare, sometimes it is the intake of particular drugs that may cause ILD. For the majority of interstitial lung diseases, the exact cause is not always known.

Both men and women of any age can develop this disease, and it is more common in people with rheumatoid arthritis, lupus, scleroderma, and autoimmune disease. Some of the primary symptoms and signs of interstitial lung disease are nonproductive dry cough, shortness of breath, and considerable weight loss. While for some types of ILDs the symptoms develop slowly and gradually over months, for others, such as the acute interstitial pneumonitis or interstitial pneumonia, the symptoms develop more rapidly, within days or a few hours.

For identifying the presence of ILD, doctors usually rely upon chest X-ray, CT scan or computed tomography, pulmonary function testing, high-resolution CT scan, and lung biopsy. In case no apparent cause behind the disease is found from the tests, a patient's history of being exposed to certain chemical environments is then taken into consideration.

Depending on the type and severity of the disease the treatment options vary from one to another. While for some taking prescribed drugs can offer a solution to prevent the lungs from deteriorating further, for some a complete lung transplant may become the only solution. Treatments like pulmonary rehabilitation and oxygen therapy can also be ideal, based on the condition of the lungs.

Thus, if one is constantly exposed to lung irritants and experiences the symptoms of interstitial lung disease for more than eight weeks, he/she must seek the advice of a pulmonologist without delay as the condition may lead to severe complications when left untreated.

Interstitial Lung Disease - Understanding Its Types!

Interstitial Lung Disease (ILD) is a term which is used for a large collection of disorders that can cause scarring of the lungs. The scarring gives rise to stiffness in the lungs that make it troublesome for breathing. Some of the examples of ILDs include Asbestosis, Hypersensitivity Pneumonitis, Sarcoidosis, and Idiopathic Pulmonary Fibrosis.


Causes -
ILDs could be caused by being exposed to dangerous chemicals, medical treatments, and certain medications. In nearly all cases, the result is unspecified. In several cases, it can be reduced by certain medications. Many drugs can harm the lungs, especially heart medications which are used to treat irregular heartbeats and hence might damage the lung tissue. Chemotherapy drugs that kill cancer cells, can also harm lung tissue.
Anti-inflammatory drugs and some antibiotics can also cause lung damage. The desecrate of the lung from many ILDs is progressive and irreversible which means it gets adverse over time. So, doctors often recommend lung transplant for the people having interstitial lung disease.

Symptoms -
The earliest symptoms and signs of interstitial lung disease are dry cough and shortness of breath at rest.

Risk Factors -
  Chemotherapy and Radiation: Using therapy drugs or having radiation treatments to chest makes it more likely to develop lung disease.
  Age: Interstitial lung disease affect adults more, although children and infants sometimes develop this disorder.
  Smoking: It occurs mostly in people who have a history of smoking. Active smoking might make the condition worse.
  Gastroesophageal Reflux Disease: If a person is having indigestion or uncontrolled acid reflux, he or she may be at risk of Interstitial Lung Disease (ILD).

Treatment -
The lung scarring or the lung fibrosis that occurs in interstitial lung disease cannot be changed and therapy will not every time be effective in stopping or finishing the ultimate development of the disease. Some treatments might slow the progression of this disease or improve symptoms temporarily. Others may help to improve quality of life. Many different scarring disorders have no proven therapies.

  Oxygen Therapy: Lung damage cannot be stopped by the oxygen therapy, but it can improve the sense of well-being and sleep because when sleeping, one receives more oxygen. It can also relax blood pressure in the right part of the heart. It can make breathing easier. Oxygen therapy can also lessen or prevent difficulty from low blood oxygen levels.
  Pulmonary Rehabilitation: Pulmonary rehabilitation not only improves daily functioning but also helps in live life fully to the people who are suffering from Interstitial Lung Disease. Pulmonary rehabilitation programs focus on breathing techniques which enhance lung efficiency, physical exercise to enhance endurance, nutritional counseling, and emotional support.

Take Away -
Interstitial Lung Disease (ILD) is a group of disorders that can be the cause of scarring of the lungs, which ultimately lead to lung damage. This condition affects more adults than children. The progression of this condition can be curtailed by adopting certain therapies.

What Is Interstitial Lung Disease?

Pericardial effusion is the excess fluid between the heart and sac surrounding the heart. The fluid keeps the heart moving in the sac. The excess fluid can cause a problem in the workings of the heart and may lead to death. The space between two layers of sac usually contain 2-3 tablespoons of clear liquid. But pericardial effusion can affect the heart beats and make it weaker.

Causes 

The leading cause of the pericardial effusion is pericarditis. In this condition, the layered sac of the heart is inflamed due to some viral infection. This inflamed sac produces more fluid.

Some of the most common infections that cause pericarditis are: 

  Viral infection 

  Cytomegalovirus 

  Coxsackieviruses 

  Echoviruses 

  HIV 

The other causes of pericarditis and pericardial effusion are: 

  Injury in the heart or the sac 

  Cancer 

  Kidney failure 

  Tuberculosis 

  Lupus 

Symptoms 

Generally, when there is minimal or no inflammation in the sac, there are no symptoms. However, chest pain and short-breathing are the most common symptoms for pericardial effusion. 

The large pericardial effusion in the heart sac can show symptoms like: 

  Shortness of breath 

  Passing out occasionally 

  Fast heart pounding 

  Fatigue 

  Clammy skin 

In some cases, where the condition is not worse, patients may experience: 

  Fever 

  Fatigue 

  Vomiting 

  Muscle aches 

  Viral illness

Diagnosis 

The person experiencing the above-mentioned symptoms should visit a cardiologist for a checkup. The doctor may ask for following tests and checkups for determining the condition: 

  Physical Checkup: In the physical checkup, the doctor listens to the heartbeat of the patient and assess the heart beat rate. He will also ask about the family history and medication records. 

  EKG: With EKG, doctors determine the heart rate with the help of electronic devices. Electrodes are placed on the chest, and heart activity is tested. However, the presence of pericardial effusion is difficult with EKG. 

  Chest X-Ray: X-Ray is an excellent way to detect the presence of pericardial effusion in the patient. The enlarged portion is detected in the image. Once an enlarged sac is detected, doctors order the echocardiogram test. It is an Ultrasound for the heart and gives a clear picture of the patient&#39;s heart condition. Once it is determined that the patient has pericardial effusion, the doctor determines the size of the enlarged sac and quantity of liquid in it. Most of the time, pericardial effusion is small and not severe. But if the size and quantity of the liquid are high, the doctor determines the condition of the heart and the ability to pump the blood. The doctor may also take a sample of the fluid from the sac to determine the exact cause for inflammation. 

Take Away 

Pericardial Effusion is a condition in which fluid is accumulated between the heart and sac surrounding the heart. Though the problem is not severe, it is advisable to consult a doctor.

Pericarditis / Pericardial Effusion - Know More About It!

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