Highlights of the American Thoracic Society conference held in Denver, CO, from May 15- 20, 2015
Here are the highlights from presentations on May 19 that considered other medical conditions that can occur in those with COPD.
1. Combined pulmonary fibrosis (lung scarring) and emphysema
Dr. Sharon Rounds from Brown University reviewed the combination of lung scarring in the lower parts of the lung with emphysema in the upper parts. This occurs more likely in men and causes low oxygen level. Treatment is the same as for COPD.
2. Pulmonary hypertension (high blood pressure in the blood vessels of the lungs)
Dr. Mark Dransfield from the University of Alabama described the presence of high pressure in the blood vessels of the lungs. This may be due to a low oxygen level and/or damage to the lining of the blood vessels. This problem can add to shortness of breath and is diagnosed usually by an echocardiogram (ultrasound of the chest). Oxygen is the major treatment.
3. Obstructive sleep apnea
As part of the highlights of the conference, Dr. Patrick Stollo from the University of Pittsburgh reported that obstructive sleep apnea may co-exist with COPD. Those who have sleep apnea typically snore at night, stop breathing for at least 10 seconds many times during sleep, and are tired during the day because of poor sleep quality. This condition is diagnosed by monitoring the oxygen level during sleep or possibly by more extensive monitoring in a sleep laboratory.
4. Lung cancer
Dr. James Jett from National Jewish Healthcare in Denver commented that even if surgery for lung cancer is not possible because of severe COPD, targeted radiation therapy may be effective with minimal damage to the lung.
5. Overlap between asthma and COPD
Dr, Claus Vogelmeier of Marburg Univeristy Hospital in Germany, discussed individuals who have features of both asthma and COPD. Treatment should be directed for asthma.
6. Assessing dyspnea (shortness of breath)
I discussed what doctors should consider when someone with COPD finds that their breathing is getting worse. One possibility is that the person with COPD is not able to inhale the medications deep into the lungs. If so, there are options including use of nebulized medications. Other considerations for worsening breathing are weight gain, being “out of shape,” having low number of red blood cells (anemia) or a heart problem. Finally, both anxiety and depression can make breathing seem more difficult. In a study performed in Lebanon, NH, individuals who had high anxiety scores reported that their breathing felt “frightening,” or “awful.”