Clinical Information A-Z

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Asbestos-related lung diseases include asbestosis (scarring of the lung), pleural plaques and mesothelioma, a particular form of cancer of the lining of the lung (pleura). The predicted peak in the number of cases of asbestos lung disease has yet to occur due to the long time interval between exposure and disease. Prompt recognition and accurate diagnosis are crucial.

Asthma is a common condition that affects nearly one in every 12 adults. Inflammation of the airways accounts for its’ symptoms of wheeze, chest tightness, cough and increased expectoration of phlegm. Whilst many patients experience mild symptoms, the condition is often chronic and thus gives rise to poor symptom control. This in turn may lead to prolonged or recurrent exacerbations that may not be particularly serious but are sufficient to interfere with lifestyle and work activities. The cornerstone of effective asthma treatment is the prevention of such episodes (thus also preventing the need for emergency care) by a combination of prophylactic measures, symptomatic relief and allergen avoidance. Although classical asthma is the allergic (atopic) form, exercise-induced and workplace-related asthma are variants within the larger group of diseases and are managed using specific measures once the diagnosis is secured.

Breathlessness (or dyspnoea) is one of the commonest symptoms in medicine. Unexplained breathlessness, particularly when experienced at rest or with low-intensity physical activity may indicate an abnormality within the respiratory tract (airways and lungs), the cardiovascular system (heart and associated circulation) or even pathology outside the chest.

Bronchiectasis is abnormal and often permanent widening (dilatation) of the airways. Its cause is not always clear although it may develop following severe childhood infections or form part of conditions such as cystic fibrosis, certain immune deficiencies, infections due to atypical mycobacteria, gastric acid reflux or ABPA (an allergic condition to fungi). Patients with bronchiectasis often have a chronic cough associated with producing increased amounts of dirty (purulent) sputum or experience more generalised symptoms such as weight loss, fever or tiredness. Effective treatment comprises bronchodilators, instruction on clearing the airways, antibiotics when necessary, immune therapies and rarely, surgery.

Injuries of the chest are very common following a fall, a sports injury or direct impact. They include simple chest wall bruising, fractured (broken) ribs, fail segment (multiple broken ribs), fractured (broken) sternum (breast bone), and problems with the rib joints (connections) to the spine (backbone) and sternum (sternum).  At the time of the injury there is a small risk of internal injuries such bleeding into the chest cavity (haemothorax) or a collapsed lung (pneumothorax) that may require urgent treatment.  Chest wall injuries can be very painful and take weeks or even months to get better. The treatment for simple broken ribs and chest wall bruising is guided restriction in activities, painkillers to allow comfortable breathing and occasionally anaesthetic injections.  In more severe injuries or when recovery takes too long further tests and specialist treatment including surgery may be required.

Chronic heavy smoking gives rise to a number of lung conditions other than COPD and lung cancer. Smokers’ bronchiolitis and a number of interstitial lung diseases have been attributed to the toxic effects of cigarette constituents. Unless specifically sought, early or subtle abnormalities of these conditions may be difficult to identify.

These deformities of the chest usually appear in childhood offend around the child’s growth spurt. There are many different deformities but they are typically divided into two main types; Pectus carinatum (or pigeon chest) where the chest is characterized by a prominence or protrusion of the ribs and breast bone; and Pectus excavatum  (hollowed or funnel chest) where the abnormal ribs and breast bone appear caved-in or sunken.  The deformity is often alone but can be apart of other deformities. Treatment if required can involve both invasive surgical correction of the deformity or non-invasive methods such as bracing.