copd

COPD (chronic obstructive pulmonary disease) is a group of lung diseases that make it hard to breathe and get worse over time.

Normally, the airways and air sacs in your lungs are elastic or stretchy. When you breathe in, the airways bring air to the air sacs. The air sacs fill up with air, like a small balloon. When you breathe out, the air sacs deflate, and the air goes out. If you have COPD, less air flows in and out of your airways because of one or more problems:

• The airways and air sacs in your lungs become less elastic
• The walls between many of the air sacs are destroyed
• The walls of the airways become thick and inflamed
• The airways make more mucus than usual and can become clogged

COPD includes two main types:

• Emphysema affects the air sacs in your lungs, as well as the walls between them. They become damaged and are less elastic.
• Chronic bronchitis, in which the lining of your airways is constantly irritated and inflamed. This causes the lining to swell and make mucus.

Most people with COPD have both emphysema and chronic bronchitis, but how severe each type is can be different from person to person.

The cause of COPD is usually long-term exposure to irritants that damage your lungs and airways. In the United States, cigarette smoke is the main cause. Pipe, cigar, and other types of tobacco smoke can also cause COPD, especially if you inhale them.

Exposure to other inhaled irritants can contribute to COPD. These include secondhand smoke, air pollution, and chemical fumes or dusts from the environment or workplace.

Rarely, a genetic condition called alpha-1 antitrypsin deficiency can play a role in causing COPD.

The risk factors for COPD include:

• Smoking. This the main risk factor. Up to 75% of people who have COPD smoke or used to smoke.
• Long-term exposure to other lung irritants, such as secondhand smoke, air pollution, and chemical fumes and dusts from the environment or workplace
• Age. Most people who have COPD are at least 40 years old when their symptoms begin.
• Genetics. This includes alpha-1 antitrypsin deficiency, which is a genetic condition. Also, smokers who get COPD are more likely to get it if they have a family history of COPD.
• Asthma. People who have asthma have more risk of developing COPD than people who don't have asthma. But most people with asthma will not get COPD.

At first, you may have no symptoms or only mild symptoms. As the disease gets worse, your symptoms usually become more severe. They can include:

• Frequent coughing or a cough that produces a lot mucus
• Wheezing
• A whistling or squeaky sound when you breathe
• Shortness of breath, especially with physical activity
• Tightness in your chest

Some people with COPD get frequent respiratory infections such as colds and the flu. In severe cases, COPD can cause weight loss, weakness in your lower muscles, and swelling in your ankles, feet, or legs.

Your health care provider may use many tools to make a diagnosis:

• A medical history, which includes asking about your symptoms
• A family history
• Various tests, such as lung function tests, a chest x-ray or CT scan, and blood tests

Your doctor will diagnose COPD based on your signs and symptoms, your medical and family histories, and test results.

There is no cure for COPD. However, treatments can help with symptoms, slow the progress of the disease, and improve your ability to stay active. There are also treatments to prevent or treat complications of the disease. Treatments include:

• Lifestyle changes, such as
  • Quitting smoking if you are a smoker. This is the most important step you can take to treat COPD.
  • Avoiding secondhand smoke and places where you might breathe in other lung irritants
  • Ask your health care provider for an eating plan that will meet your nutritional needs. Also ask about how much physical activity you can do. Physical activity can strengthen the muscles that help you breathe and improve your overall wellness.
• Medicines, such as
  • Bronchodilators, which relax the muscles around your airways. This helps open your airways and makes breathing easier. Most bronchodilators are taken through an inhaler. In more severe cases, the inhaler may also contain steroids to reduce inflammation.
  • Vaccines for the flu and pneumococcal pneumonia, since people with COPD are at higher risk for serious problems from these diseases
  • Antibiotics if you get a bacterial or viral lung infection
• Oxygen therapy, if you have severe COPD and low levels of oxygen in your blood. Oxygen therapy can help you breathe better. You may need extra oxygen all the time or only at certain times.
• Pulmonary rehabilitation, which is a program that helps improve the well-being of people who have chronic breathing problems. It may include
  • An exercise program
  • Disease management training
  • Nutritional counseling
  • Psychological counseling
• Surgery, usually as a last resort for people who have severe symptoms that have not gotten better with medicines:
  • For COPD that is mainly related to emphysema, there are surgeries that
    • Remove damaged lung tissue
    • Remove large air spaces (bullae) that can form when air sacs are destroyed. The bullae can interfere with breathing.
  • For severe COPD, some people may need lung transplant

If you have COPD, it's important to know when and where to get help for your symptoms. You should get emergency care if you have severe symptoms, such as trouble catching your breath or talking. Call your health care provider if your symptoms are getting worse or if you have signs of an infection, such as a fever.

Since smoking causes most cases of COPD, the best way to prevent it is to not smoke. It's also important to try to avoid lung irritants such as secondhand smoke, air pollution, chemical fumes, and dusts.

NIH: National Heart, Lung, and Blood Institute

Emphysema is a type of COPD (chronic obstructive pulmonary disease). COPD is a group of lung diseases that make it hard to breathe and get worse over time. The other main type of COPD is chronic bronchitis. Most people with COPD have both emphysema and chronic bronchitis, but how severe each type is can be different from person to person.

Emphysema affects the air sacs in your lungs. Normally, these sacs are elastic or stretchy. When you breathe in, each air sac fills up with air, like a small balloon. When you breathe out, the air sacs deflate, and the air goes out.

In emphysema, the walls between many of the air sacs in the lungs are damaged. This causes the air sacs to lose their shape and become floppy. The damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones. This makes it harder for your lungs to move oxygen in and carbon dioxide out of your body.

The cause of emphysema is usually long-term exposure to irritants that damage your lungs and the airways. In the United States, cigarette smoke is the main cause. Pipe, cigar, and other types of tobacco smoke can also cause emphysema, especially if you inhale them.

Exposure to other inhaled irritants can contribute to emphysema. These include secondhand smoke, air pollution, and chemical fumes or dusts from the environment or workplace.

Rarely, a genetic condition called alpha-1 antitrypsin deficiency can play a role in causing emphysema.

The risk factors for emphysema include:

• Smoking. This the main risk factor. Up to 75% of people who have emphysema smoke or used to smoke.
• Long-term exposure to other lung irritants, such as secondhand smoke, air pollution, and chemical fumes and dusts from the environment or workplace.
• Age. Most people who have emphysema are at least 40 years old when their symptoms begin.
• Genetics. This includes alpha-1 antitrypsin deficiency, which is a genetic condition. Also, smokers who get emphysema are more likely to get it if they have a family history of COPD.

At first, you may have no symptoms or only mild symptoms. As the disease gets worse, your symptoms usually become more severe. They can include:

• Frequent coughing or wheezing
• A cough that produces a lot mucus
• Shortness of breath, especially with physical activity
• A whistling or squeaky sound when you breathe
• Tightness in your chest

Some people with emphysema get frequent respiratory infections such as colds and the flu. In severe cases, emphysema can cause weight loss, weakness in your lower muscles, and swelling in your ankles, feet, or legs.

Your health care provider may use many tools to make a diagnosis:

• A medical history, which includes asking about your symptoms
• A family history
• Other tests tests, such as lung function tests, a chest x-ray or CT scan, and blood tests

There is no cure for emphysema. However, treatments can help with symptoms, slow the progress of the disease, and improve your ability to stay active. There are also treatments to prevent or treat complications of the disease. Treatments include:

• Lifestyle changes, such as
  • Quitting smoking if you are a smoker. This is the most important step you can take to treat emphysema.
  • Avoiding secondhand smoke and places where you might breathe in other lung irritants
  • Ask your health care provider for an eating plan that will meet your nutritional needs. Also ask about how much physical activity you can do. Physical activity can strengthen the muscles that help you breathe and improve your overall wellness.
• Medicines, such as
  • Bronchodilators, which relax the muscles around your airways. This helps open your airways and makes breathing easier. Most bronchodilators are taken through an inhaler. In more severe cases, the inhaler may also contain steroids to reduce inflammation.
  • Vaccines for the flu and pneumococcal pneumonia, since people with emphysema are at higher risk for serious problems from these diseases
  • Antibiotics if you get a bacterial or viral lung infection
• Oxygen therapy, if you have severe emphysema and low levels of oxygen in your blood. Oxygen therapy can help you breathe better. You may need extra oxygen all the time or only at certain times.
• Pulmonary rehabilitation, which is a program that helps improve the well-being of people who have chronic breathing problems. It may include
  • An exercise program
  • Disease management training
  • Nutritional counseling
  • Psychological counseling
• Surgery, usually as a last resort for people who have severe symptoms that have not gotten better with medicines. There are surgeries to
  • Remove damaged lung tissue
  • Remove large air spaces (bullae) that can form when air sacs are destroyed. The bullae can interfere with breathing.
  • Do a lung transplant. This is might be an option if you have very severe emphysema.

If you have emphysema, it's important to know when and where to get help for your symptoms. You should get emergency care if you have severe symptoms, such as trouble catching your breath or talking. Call your health care provider if your symptoms are getting worse or if you have signs of an infection, such as a fever.

Since smoking causes most cases of emphysema, the best way to prevent it is to not smoke. It's also important to try to avoid lung irritants such as secondhand smoke, air pollution, chemical fumes, and dusts.

NIH: National Heart, Lung, and Blood Institute

Chronic bronchitis is a type of COPD (chronic obstructive pulmonary disease). COPD is a group of lung diseases that make it hard to breathe and get worse over time. The other main type of COPD is emphysema. Most people with COPD have both emphysema and chronic bronchitis, but how severe each type is can be different from person to person.

Chronic bronchitis is inflammation (swelling) and irritation of the bronchial tubes. These tubes are the airways that carry air to and from the air sacs in your lungs. The irritation of the tubes causes mucus to build up. This mucus and the swelling of the tubes make it harder for your lungs to move oxygen in and carbon dioxide out of your body.

The cause of chronic bronchitis is usually long-term exposure to irritants that damage your lungs and airways. In the United States, cigarette smoke is the main cause. Pipe, cigar, and other types of tobacco smoke can also cause chronic bronchitis, especially if you inhale them.

Exposure to other inhaled irritants can contribute to chronic bronchitis. These include secondhand smoke, air pollution, and chemical fumes or dusts from the environment or workplace.

Rarely, a genetic condition called alpha-1 antitrypsin deficiency can play a role in causing chronic bronchitis.

The risk factors for chronic bronchitis include:

• Smoking. This the main risk factor. Up to 75% of people who have chronic bronchitis smoke or used to smoke.
• Long-term exposure to other lung irritants, such as secondhand smoke, air pollution, and chemical fumes and dusts from the environment or workplace.
• Age. Most people who have chronic bronchitis are at least 40 years old when their symptoms begin.
• Genetics. This includes alpha-1 antitrypsin deficiency, which is a genetic condition. Also, smokers who get chronic bronchitis are more likely to get it if they have a family history of COPD.

At first, you may have no symptoms or only mild symptoms. As the disease gets worse, your symptoms usually become more severe. They can include:

• Frequent coughing or a cough that produces a lot mucus
• Wheezing
• A whistling or squeaky sound when you breathe
• Shortness of breath, especially with physical activity
• Tightness in your chest

Some people with chronic bronchitis get frequent respiratory infections such as colds and the flu. In severe cases, chronic bronchitis can cause weight loss, weakness in your lower muscles, and swelling in your ankles, feet, or legs.

Your health care provider may use many tools to make a diagnosis:

• A medical history, which includes asking about your symptoms
• A family history
• Various tests, such as lung function tests, a chest x-ray or CT scan, and blood tests

There is no cure for chronic bronchitis. However, treatments can help with symptoms, slow the progress of the disease, and improve your ability to stay active. There are also treatments to prevent or treat complications of the disease. Treatments include:

• Lifestyle changes, such as
  • Quitting smoking if you are a smoker. This is the most important step you can take to treat chronic bronchitis.
  • Avoiding secondhand smoke and places where you might breathe in other lung irritants
  • Ask your health care provider for an eating plan that will meet your nutritional needs. Also ask about how much physical activity you can do. Physical activity can strengthen the muscles that help you breathe and improve your overall wellness.
• Medicines, such as
  • Bronchodilators, which relax the muscles around your airways. This helps open your airways and makes breathing easier. Most bronchodilators are taken through an inhaler. In more severe cases, the inhaler may also contain steroids to reduce inflammation.
  • Vaccines for the flu and pneumococcal pneumonia, since people with chronic bronchitis are at higher risk for serious problems from these diseases.
  • Antibiotics if you get a bacterial or viral lung infection
• Oxygen therapy, if you have severe chronic bronchitis and low levels of oxygen in your blood. Oxygen therapy can help you breathe better. You may need extra oxygen all the time or only at certain times.
• Pulmonary rehabilitation, which is a program that helps improve the well-being of people who have chronic breathing problems. It may include
• An exercise program
• Disease management training
• Nutritional counseling
• Psychological counseling
• A lung transplant, as a last resort for people who have severe symptoms that have not gotten better with medicines

If you have chronic bronchitis, it's important to know when and where to get help for your symptoms. You should get emergency care if you have severe symptoms, such as trouble catching your breath or talking. Call your health care provider if your symptoms are getting worse or if you have signs of an infection, such as a fever.

Since smoking causes most cases of chronic bronchitis, the best way to prevent it is to not smoke. It's also important to try to avoid lung irritants such as secondhand smoke, air pollution, chemical fumes, and dusts.

NIH: National Heart, Lung, and Blood Institute

Pulmonary rehabilitation, also known as pulmonary rehab or PR, is a program for people who have chronic (ongoing) breathing problems. It can help improve your ability to function and quality of life. PR does not replace your medical treatment. Instead, you use them together.

PR is often an outpatient program that you do in a hospital or clinic. Some people have PR in their homes. You work with a team of health care providers to find ways to lessen your symptoms, increase your ability to exercise, and make it easier to do your daily activities.

Your health care provider may recommend pulmonary rehabilitation (PR) if you have a chronic lung disease or another condition that makes it hard for you to breathe and limits your activities. For example, PR may help you if you:

• Have COPD (chronic obstructive pulmonary disease). The two main types are emphysema and chronic bronchitis. In COPD, your airways (tubes that carry air in and out of your lungs) are partially blocked. This makes it hard to get air in and out.
• Have an interstitial lung disease such as sarcoidosis and pulmonary fibrosis. These diseases cause scarring of the lungs over time. This makes it hard to get enough oxygen.
• Have cystic fibrosis (CF). CF is an inherited disease that causes thick, sticky mucus to collect in the lungs and block the airways.
• Need lung surgery. You may have PR before and after lung surgery to help you prepare for and recover from the surgery.
• Have a muscle-wasting disorder that affects the muscles used for breathing. An example is muscular dystrophy.

PR works best if you start it before your disease is severe. However, even people who have advanced lung disease can benefit from PR.

When you first start pulmonary rehabilitation (PR), your team of health care providers will want to learn more about your health. You will have lung function, exercise, and possibly blood tests. Your team will go over your medical history and current treatments. They may check on your mental health and ask about your diet. Then they will work together to create a plan that is right for you. It may include:

• Exercise training. Your team will come up with an exercise plan to improve your endurance and muscle strength. You will likely have exercises for both your arms and legs. You might use a treadmill, stationary bike, or weights. You may need to start slowly and increase your exercise as you get stronger.
• Nutritional counseling. Being either overweight or underweight can affect your breathing. A nutritious eating plan can help you work towards a healthy weight.
• Education about your disease and how to manage it. This includes learning how to avoid situations that make your symptoms worse, how to avoid infections, and how/when to take your medicines.
• Techniques you can use to save your energy. Your team may teach you easier ways to do daily tasks. For example, you may learn ways to avoid reaching, lifting, or bending. Those movements make it harder to breathe, since they use up energy and make you tighten your abdominal muscles. You may also learn how to better deal with stress, since stress can also take up energy and affect your breathing.
• Breathing strategies. You will learn techniques to improve your breathing. These techniques may increase your oxygen levels, decrease how often you take breaths, and keep your airways open longer.
• Psychological counseling and/or group support. It can feel scary to have trouble breathing. If you have a chronic lung disease, you are more likely to have depression, anxiety, or other emotional problems. Many PR programs include counseling and/or support groups. If not, your PR team may be able to refer you to an organization that offers them.

NIH: National Heart, Lung, and Blood Institute

There's no way around it; smoking is bad for your health. It harms nearly every organ of the body, even some that you would not expect. Cigarette smoking causes many cancers and other health problems. It is also the cause of nearly one in five deaths in the United States.

Some of the many health problems that smoking can cause include:

• Cancers. Smoking is the most common cause of lung and oral cancers. But it can also cause cancer in many other parts of your body, such as in your larynx (voice box), esophagus, throat, bladder, kidney, liver, stomach, pancreas, colon and rectum, and cervix. It can also cause acute myeloid leukemia (AML).
• Lung diseases. Smoking is the most common cause of COPD. It can also worsen asthma and raise your risk of pneumonia.
• Cardiovascular diseases. Smoking can damage your blood vessels and make them thicken and grow narrower. This makes your heart beat faster and raises your blood pressure. Smoking also increases your risk of blood clots and stroke.
• Vision problems. Smoking can raise your risk of cataracts and cause macular degeneration (AMD).

People who smoke while pregnant have a greater chance of certain pregnancy problems. Their babies are also at higher risk of dying of sudden infant death syndrome (SIDS).

Smoking also causes addiction to nicotine, a stimulant drug that is in tobacco. Nicotine addiction makes it much harder for people to quit smoking.

Your smoke is also bad for other people. If they breathe in your secondhand smoke, they can get many of the same problems as smokers do. These problems can include heart disease and lung cancer. Children exposed to secondhand smoke have a higher risk of ear infections, colds, pneumonia, bronchitis, and more severe asthma. People who breathe secondhand smoke while pregnant are more likely to have preterm labor and babies with low birth weight.

Besides cigarettes, there are several other forms of tobacco. Some people smoke tobacco in cigars and water pipes (hookahs). These forms of tobacco also contain harmful chemicals and nicotine. Some cigars contain as much tobacco as an entire pack of cigarettes.

E-cigarettes often look like cigarettes, but they work differently. They are battery-operated smoking devices. Using an e-cigarette is called vaping. Researchers still have a lot to learn about the health effects of using e-cigarettes. We do know that they contain nicotine, which is highly addictive and is a health danger for pregnant people, their developing babies, children, and teens. And e-cigarettes also expose non-smokers to secondhand aerosols (rather than secondhand smoke), which contain harmful chemicals.

Smokeless tobacco, such as chewing tobacco and snuff, is also bad for your health. Smokeless tobacco can cause certain cancers, including oral cancer. It also increases your risk of getting heart disease, gum disease, and oral lesions.

Remember, there is no safe level of tobacco use. Smoking even just one cigarette per day over a lifetime can cause smoking-related cancers and premature death. Quitting smoking can reduce your risk of health problems and add years to your life. The earlier you quit, the greater the benefit. Some immediate benefits of quitting include:

• Lower heart rate and blood pressure
• Less carbon monoxide in the blood (carbon monoxide reduces the blood's ability to carry oxygen)
• Better circulation
• Less coughing and wheezing

Quitting smoking can be challenging, but it is so important for your health. Contact your health care provider if you need help quitting.

Asthma is a chronic (long-term) lung disease. It affects your airways, the tubes that carry air in and out of your lungs. When you have asthma, your airways can become inflamed and narrowed. This can cause wheezing, coughing, and tightness in your chest. When these symptoms get worse than usual, it is called an asthma attack or flare-up.

The exact cause of asthma is unknown. Genetics and your environment likely play a role in who gets asthma.

An asthma attack can happen when you are exposed to an asthma trigger. An asthma trigger is something that can set off or worsen your asthma symptoms. Different triggers can cause different types of asthma:

• Allergic asthma is caused by allergens. Allergens are substances that cause an allergic reaction. They can include
  • Dust mites
  • Mold
  • Pets
  • Pollen from grass, trees, and weeds
  • Waste from pests such as cockroaches and mice
• Nonallergic asthma is caused by triggers that are not allergens, such as
  • Breathing in cold air
  • Certain medicines
  • Household chemicals
  • Infections such as colds and the flu
  • Outdoor air pollution
  • Tobacco smoke
• Occupational asthma is caused by breathing in chemicals or industrial dusts at work
• Exercise-induced asthma happens during physical exercise, especially when the air is dry

Asthma triggers may be different for each person and can change over time.

Asthma affects people of all ages, but it often starts during childhood. Certain factors can raise your risk of having asthma:

• Being exposed to secondhand smoke when your mother is pregnant with you or when you are a small child
• Being exposed to certain substances at work, such as chemical irritants or industrial dusts
• Genetics and family history. You are more likely to have asthma if one of your parents has it, especially if it's your mother.
• Race or ethnicity. Black and African Americans and Puerto Ricans are at higher risk of asthma than people of other races or ethnicities.
• Having other diseases or conditions such as obesity and allergies
• Often having viral respiratory infections as a young child
• Sex. In children, asthma is more common in boys. In teens and adults, it is more common in women.

The symptoms of asthma include:

• Chest tightness
• Coughing, especially at night or early morning
• Shortness of breath
• Wheezing, which causes a whistling sound when you breathe out

These symptoms can range from mild to severe. You may have them every day or only once in a while.

When you are having an asthma attack, your symptoms get much worse. The attacks may come on gradually or suddenly. Sometimes they can be life-threatening. They are more common in people who have severe asthma. If you are having asthma attacks, you may need a change in your treatment.

Your health care provider may use many tools to diagnose asthma:

• Physical exam
• Medical history
• Lung function tests, including spirometry, to test how well your lungs work
• Tests to measure how your airways react to specific exposures. During this test, you inhale different concentrations of allergens or medicines that may tighten the muscles in your airways. Spirometry is done before and after the test.
• Peak expiratory flow (PEF) tests to measure how fast you can blow air out using maximum effort
• Fractional exhaled nitric oxide (FeNO) tests to measure levels of nitric oxide in your breath when you breathe out. High levels of nitric oxide may mean that your lungs are inflamed.
• Allergy skin or blood tests, if you have a history of allergies. These tests check which allergens cause a reaction from your immune system.

If you have asthma, you will work with your health care provider to create a treatment plan. The plan will include ways to manage your asthma symptoms and prevent asthma attacks. It will include:

• Strategies to avoid triggers. For example, if tobacco smoke is a trigger for you, you should not smoke or allow other people to smoke in your home or car.
• Short-term relief medicines, also called quick-relief medicines. They help prevent symptoms or relieve symptoms during an asthma attack. They include an inhaler to carry with you all the time. It may also include other types of medicines which work quickly to help open your airways.
• Control medicines. You take them every day to help prevent symptoms. They work by reducing airway inflammation and preventing narrowing of the airways.

If you have a severe attack and the short-term relief medicines do not work, you will need emergency care.

Your provider may adjust your treatment until asthma symptoms are controlled.

Sometimes asthma is severe and cannot be controlled with other treatments. If you are an adult with uncontrolled asthma, in some cases your provider might suggest bronchial thermoplasty. This is a procedure that uses heat to shrink the smooth muscle in the lungs. Shrinking the muscle reduces your airway's ability to tighten and allows you to breathe more easily. The procedure has some risks, so it's important to discuss them with your provider.

Alpha-1 antitrypsin deficiency (AAT deficiency, or AATD) is an inherited condition that raises your risk for lung and liver disease. If you have this condition, your body doesn't make enough alpha-1 antitrypsin (AAT).

AAT is made by your liver. It helps protect your lungs from inflammation and irritating substances you might breathe in, such as smoke. If your liver doesn't make enough AAT, your lungs may be more easily damaged from smoking, pollution, or dust from the environment. This can lead to a serious lung condition called chronic obstructive pulmonary disease (COPD). AAT deficiency may also cause a liver disease called cirrhosis. This is more common in children who have AAT deficiency.

AAT deficiency is a genetic disorder. That means it's caused by changes in your genes, which may also be called gene variants or mutations.

Your genes carry information that controls what you look like and how your body works. AAT deficiency is caused by changes in the SERPINA1 gene, which carries instructions for making the AAT protein. These gene changes are inherited from your parents, so AAT deficiency tends to run in families:

• If you have two mutated copies of the gene, it means you have a condition called AAT deficiency. People with this disorder have a higher risk of getting lung disease or liver damage before the age of 45.
• If you have one mutated copy of the gene, you are a carrier of AAT deficiency. In these cases, this means you are at slightly higher risk of developing lung disease, especially if you have other risk factors, such as being a smoker. You could still pass the mutated gene on to your children.

There are a few gene changes that cause AAT deficiency. These gene changes can:

• Decrease the amount of AAT protein your liver makes.
• Prevent your liver from making any AAT.
• Affect the shape of the AAT protein so that it can't move out of your liver to protect your lungs. Over time, AAT builds up in your liver and causes damage.

Some people who have AAT deficiency do not have any symptoms. For those who do, symptoms usually appear in people between 20 and 50 years old. These symptoms may include:

• Wheezing
• Shortness of breath, especially after exercise
• Chronic cough with phlegm (mucus)
• Repeated respiratory infections such as colds and the flu
• Chest pain
• Fatigue
• Faster-than-normal heartbeat when you stand up
• Vision problems
• Losing weight without trying

Some people who have AAT deficiency may have liver damage. Signs of liver damage include jaundice (a condition that causes your skin and eyes to turn yellow) and swelling in your legs.

Rarely, AAT deficiency can cause skin problems, such as painful lumps or patches.

Your health care provider may test you for AAT deficiency if you have:

• Symptoms of AAT deficiency
• A condition that could be related to AAT deficiency
• Relatives who have AAT deficiency
• Relatives who have a lung or liver disease that could be related to AAT deficiency

AAT deficiency in babies often affects the liver. Your baby may need AAT testing if he or she has signs of liver disease such as jaundice or abnormal liver enzyme tests.

A blood test can check the level of AAT protein in your blood. If the level is lower than normal, it is likely that you have AAT deficiency.

A genetic test is the most certain way to check for AAT deficiency and should be done to confirm the results of the blood test. There are two types of genetic tests:

• A genotype test looks for the more common types of gene changes that can cause AAT deficiency.
• A phenotype test checks for changes in the AAT protein that change how it would normally work.

If your lungs are affected, you may also have lung function tests to see how well your lungs are working.

There is no cure for AAT deficiency, but there are treatments to help with the symptoms and slow the lung damage it causes. Treatment options may include:

• Inhaled medicines to help you breathe better.
• Pulmonary rehabilitation.
• Oxygen therapy.
• Augmentation therapy, which is a lifelong treatment. It raises the levels of the AAT protein in your lungs, using ATT protein taken from the blood of donors. It helps slow down lung damage. It cannot prevent liver damage.
• Lung surgery or a lung transplant, if your lungs are severely damaged.
• Liver transplant, if your liver is severely damaged.

To help prevent or delay lung damage, it is important to quit smoking (if you smoke) and avoid secondhand smoke, dust, and air pollution. Ask your provider If you need to stop drinking alcohol.

Atrial fibrillation, also known as AFib or AF, is one of the most common types of arrhythmias. Arrhythmias are problems with the rate or rhythm of your heartbeat. They can cause your heart to beat too slowly, too fast, or in an irregular way.

If you have AFib, your heart beats irregularly and sometimes much faster than normal. Also, your heart's upper and lower chambers do not work together as they should. When this happens, the lower chambers do not fill completely or pump enough blood to your lungs and body. This can cause symptoms such as dizziness, fatigue, and a pounding heartbeat.

AFib may happen in brief episodes, or it may be a permanent condition. It's very important to treat it, since AFib can put you at risk for stroke and other heart conditions.

AFib is most often caused by changes to the heart's tissue or the electrical signaling that helps the heartbeat. These changes can happen due to different conditions and factors, such as high blood pressure, coronary artery disease, congenital heart defects, infections, and aging. Sometimes the cause is unknown.

Anyone can develop AFib, but there are certain things that raise your risk for it:

• Aging. The risk of atrial fibrillation increases as you get older, especially when you are over age 65.
• Family history and genetics. AFib can run in families. So can heart disease, which raises your risk of AFib.
• Some lifestyle choices. Your risk is higher if you drink a lot of alcohol, use certain illegal drugs such as cocaine and methamphetamines, or smoke.
• Having certain health conditions, such as:
  • High blood pressure
  • Diabetes
  • Heart failure
  • Heart valve diseases
  • Obesity
  • Hyperthyroidism
  • Chronic kidney disease
  • COPD and other lung diseases
  • Sleep apnea
• Race. AFib is more common in people with European ancestry.
• Recent surgery. You may be at risk of atrial fibrillation in the early days and weeks after surgery on your heart, lungs, or esophagus.

Some people who have AFib don't have any symptoms and don't know they have it. If you do have symptoms, you may only notice them once in a while. Or you may have symptoms that are more frequent. And in some cases, the symptoms might be severe. If you have heart disease, you are more likely to notice your symptoms. And those symptoms could get worse if your heart disease gets worse.

The symptoms of AFib can include:

• Extreme fatigue, which is the most common symptom
• Heart palpitations (the feeling that your heart is skipping a beat, fluttering, pounding, or beating too hard or too fast)
• Trouble breathing, especially when lying down or when exercising
• Chest pain
• Dizziness or fainting
• Low blood pressure

If AFib is not treated, it can lead to serious health problems (complications) such as:

• Stroke
• Heart failure
• Blood clots
• Sudden cardiac arrest (SCA)
• Cognitive impairment and dementia

To help prevent these problems, it's important to contact your health care provider if you are having symptoms. If you do have AFib, the sooner you are diagnosed and treated, the better.

To find out if you have AFib, your provider:

• Will ask about your medical history, including your symptoms, lifestyle, and any other health conditions you may have
• Will ask about your family history, to find out if you have relatives who have or had AFib
• Will do a physical exam
• May order blood tests
• Will likely order heart tests, such as an electrocardiogram (also called an EKG or ECG) and echocardiogram
• May ask you to wear a heart monitor device that records your heart's electrical activity

The treatments for AFib may include:

• Blood thinner medicines that help prevent blood clots from forming.
• Medicines to control your heart's rhythm and rate.
• Following heart-healthy lifestyle changes, such as:
  • Following a heart-healthy eating plan that limits saturated fats, salt, and cholesterol. An example is the DASH eating plan.
  • Limiting or avoiding alcohol, because it can increase your heart rate.
  • Aiming for a healthy weight.
  • Getting regular physical activity.
  • Managing stress.
  • Quitting smoking.
• Procedures such as:
  • Electrical cardioversion, which restores your heart rhythm using low-energy shocks to your heart.
  • Catheter ablation, which scars the tissue that is causing the arrhythmia. The scar tissue blocks the abnormal heart signals.
• Surgeries such as:
  • Surgery to put in a pacemaker to help control the arrhythmia.
  • A Maze procedure, which creates scar tissue in a maze-like pattern in certain parts of the heart.
  • Left atrial appendage closure, a surgery on a small sac in the muscle wall of your left atrium (the upper left chamber of your heart). It helps prevent blood clots and can reduce your risk of stroke. This surgery is for people who are not able to take blood thinners.

There are steps you can take to help lower your risk of atrial fibrillation, such as:

• Making heart-healthy lifestyle changes:
  • Following a heart-healthy eating plan
  • Limiting or avoiding alcohol
  • Aiming for a healthy weight
  • Getting regular physical activity
  • Managing stress
  • Not smoking
• Avoiding illegal drugs, such as cocaine and methamphetamines
• Taking antiarrhythmic medicine (medicine to treat arrhythmia) if you are having heart surgery
• Treating any health conditions that could raise your risk of AFib

NIH: National Heart, Lung, and Blood Institute

Coughing is a reflex that keeps your throat and airways clear. Although it can be annoying, coughing helps your body heal or protect itself. Coughs can be either acute or chronic. Acute coughs begin suddenly and usually last no more than 2 to 3 weeks. Acute coughs are the kind you most often get with a cold, flu, or acute bronchitis. Chronic coughs last longer than 2 to 3 weeks. Causes of chronic cough include:

• Chronic bronchitis
• Asthma
• Allergies
• COPD (chronic obstructive pulmonary disease)
• GERD (gastroesophageal reflux disease)
• Smoking
• Throat disorders, such as croup in young children
• Some medicines

Water can help ease your cough - whether you drink it or add it to the air with a steamy shower or vaporizer. If you have a cold or the flu, antihistamines may work better than non-prescription cough medicines. Children under four should not have cough medicine. For children over four, use caution and read labels carefully.

A disability is any condition of your body or mind that makes it more difficult for you to do one or more major life activities and interact with the world around you.

There are many types of disabilities, such as those that can affect your:

• Vision
• Hearing
• Movement
• Thinking
• Remembering
• Learning
• Communicating
• Development
• Mental health
• Social relationships

More than 1 in 4 adults in the United States have some type of disability. Even though they all have disabilities, they can have a wide range of needs. For example, even people who have same type of disability can be affected in very different ways. Also, some disabilities are "visible" (easy to see), for example when someone is in a wheelchair. But other disabilities are "invisible" (hidden or not easy to see), such as problems with hearing, thinking, or learning.

Disabilities can have different causes. Some disabilities are present at birth, while others may happen later in life.

Causes of disabilities that are present at birth can include:

• Disorders in single genes, such as Duchenne muscular dystrophy
• Disorders of chromosomes, such as Down syndrome
• Exposures (before birth) to infections or substances, such as drugs, alcohol, or cigarettes

Causes of disabilities that happen later in life can include:

• Injuries, such as spinal cord injuries, traumatic brain injuries (TBIs), and back injuries
• Chronic (long-lasting) diseases, such as diabetes, heart disease, kidney disease, COPD, and arthritis
• Cancer
• Mental health problems
• Stroke
• Alzheimer's disease and other causes of dementia

Having a disability does not mean a person cannot be healthy. In fact, many people with disabilities report that their health as good or better. But they may have or be at risk of health problems related to their disability, called "secondary conditions." These conditions may include:

• Bowel or bladder problems
• Chronic pain
• Diabetes
• Fatigue
• Heart disease
• Injuries
• Mental health problems, including depression and substance use disorders
• Overweight and obesity
• Pressure sores or ulcers

Many of these conditions can be prevented, and there are treatments for them. It's also important for people with disabilities to get health care that meets their needs as a whole person, not just as a person with a disability.

Just like for people who don't have a disability, having a healthy lifestyle is important for people who do have a disability. A healthy lifestyle includes:

• Getting regular physical activity
• Eating healthy foods in healthy portions
• Limiting sun exposure and using sunscreen to prevent skin cancer
• Not smoking, and if needed, getting help to quit smoking
• Using medicines wisely
• Not drinking alcohol or drinking in moderation
• Getting help for any substance use or mental health problems
• Staying in touch with family and friends

Managing a disability can sometimes be challenging. There are resources that can help:

• Assistive devices and mobility aids can make daily tasks easier.
• Schools can develop plans around the specific needs of a child with a disability. The goal of the plans is to give the child an opportunity to perform at the same level as other children their age.
• Support networks, such as disability organizations, can help you learn more about resources for you and your family. Support groups can help you connect with other people who have the same disability. They can provide emotional and social support. They are also a place where people can share tips about how to deal with day-to-day challenges.
• Government programs may provide benefits, job training, employment resources, and protection against discrimination.

Centers for Disease Control and Prevention