Pulmonary disease is any abnormal condition of the respiratory system, characterized by cough, chest pain, dyspnea, hemoptysis, sputum production, stridor, or adventitious sounds. While physicians are often able to address and control the symptoms of pulmonary disease, it is typically with limited success if the acute cause is not diagnosed.
There are different categories of pulmonary disease, and the diagnosis and management of each specific category is necessary for clinicians to ensure that patients are successful in their management and treatment of pulmonary disease. Tobacco usage, Chronic Obstructive Pulmonary Disease (COPD), unexplained chronic cough, obstructive sleep apnea, asthma, bronchitis, and other categories of pulmonary disease may all manifest themselves in different ways and will require treatment that is specific to the condition.
Many of the symptoms that stem from pulmonary disease are often overlooked at the onset of the disease. Headaches, facial pain, joint pain, arm and shoulder pain, anxiety, and tenderness in the calf of the leg (among other less common symptoms) are often first associated with other conditions or diseases, subjecting patients to longer suffering without proper intervention. Due to the commonalities of many symptoms, physicians must often dig deeper to find the root cause of the problem rather than missing what is a potentially life-threatening condition. With guidelines put into practice, physicians have a standard for which to evaluate patients – those with obvious symptoms and those whose symptoms are often misdiagnosed.
Field walking tests can consistently be employed by clinicians and researchers to evaluate exercise capacity, assess prognosis, and evaluate treatment response. Field walking tests can be used in any annual physical to evaluate patients with known pulmonary conditions, and it is also a tool that can identify unknown cases of pulmonary disease. For instance, if a patient walks in the 6-min walk distance test (6MWD or 6MWT) and at minute 4 they begin to experience a headache or pain in the arm or shoulder physicians can automatically become concerned with a pulmonary connection. The key in this simple field walking test is that symptoms will relationally manifest themselves with measures of exercise performance and physical activity. From this point, the Incremental Shuttle Walk Test (ISWT) and the Endurance Shuttle Walk Test (ESWT) can be performed to exhibit good test-retest reliability.
Due to the variance in pulmonary conditions and the ways in which they exhibit themselves, physicians must be able to successfully identify pulmonary concerns sooner rather than later. Guidelines surrounding the thorough evaluation of patients and the common and uncommon symptoms of pulmonary disease allow physicians to better evaluate their patients and provide successful, and earlier intervention.
- American College of Chest Physicians
- American Thoracic Society
- European Respiratory Society
- Global Initiative for Chronic Obstructive Lung Disease (GOLD)
- Global Initiative for Asthma (GINA)
- 2020 Pharmacologic Management of Chronic Obstructive Pulmonary Disease. An Official American Thoracic Society Clinical Practice Guidelines
- 2020 Initiating Pharmacologic Treatment in Tobacco-Dependent Adults An Official American Thoracic Society Clinical Practice Guideline
- 2020 Long-term noninvasive ventilation in chronic stable hypercapnic chronic obstructive pulmonary disease
- 2017 UofM Chronic Obstructive Pulmonary Disease
- COPD Insider – register for updates on best practices
- University of Michigan 2016 Acute Exacerbation of COPD
- USPSTF 2017 Screening in Obstructive Sleep Apnea Recommendation Statement
- 2016 American Academy of Sleep Medicine - Management of Central Sleep Apnea
- AHRQ 2016 Treatment of Unexplained Chronic Cough
- Pulmonary Guidelines/2016 USPSTF COPD Screening