COPD stands for Chronic Obstructive Pulmonary Disease and includes emphysema and bronchitis pathology.  Although there may be some element of spasm in the airways like asthma, the main regions of destruction are the air sacs or alveoli in the lung.  This is where oxygen exchange occurs, and destruction of the tissue results in low tissue oxygen levels that translate to symptoms of shortness of breath.

There is a genetic disorder called alpha one antitrypsin deficiency that can cause emphysema-like lung destruction, but by far the most common cause is cigarette smoke exposure.  The toxins in cigarette smoke lead to lung inflammation that can ultimately lead to irreversible and progressive tissue destruction.  Because there may not be significant reversible spasm of the airways, the drug therapy for COPD can be frustrating for both patient and Physician – PREVENTION is therefore the best treatment and studies have shown a benefit to smoking cessation at all points of the patients’ life.  Other modalities, including vaccinations for the flu and pneumonia, as well as pulmonary rehabilitation programs and exercise regimens are important for maintaining lung health.

The diagnosis of COPD is multifaceted and includes a thorough history and physical examination, x-ray evaluation, and pulmonary function testing.  Chest X-ray and CT scan alone, although suggestive, are not enough to confirm a diagnosis of COPD.

Normal Lungs and Lungs With COPD

COPD - Emphesyma

Source: National Heart, Lung and Blood Institute