Spirometry | Test for Lung Function | Nucleus Health
How to Diagnose Lung Problems
Lung disorders come in many forms, from long-developing problems like COPD or cancer to sudden-onset issues like blood clots or a collapsed lung. These various lung problems often share similar symptoms, such as shortness of breath, wheezing, and excess mucus production. Likewise, many of the diagnostic techniques, such as blood work, chest x-rays and breathing tests, are also often similar. If you suspect any type of lung problem, it’s important to get checked out by your doctor right away.
Identifying Lung Disorders
Get checked for a collapsed lung if you have sudden-onset symptoms.A pneumothorax (collapsed lung) can be caused by long-term problems like lung cancer, but can also be the result of puncture wounds (like being stabbed or shot) or other traumatic injuries to the chest. The symptoms of a collapsed lung will occur almost immediately.
- You’ll likely experience sudden-onset shortness of breath and chest pain, and you may have rapid breathing or heart rate, bluish skin, and fatigue.
- Your doctor will diagnose a pneumothorax by physical exam, which will include a chest x-ray.
- If you have a mild case, it may resolve on its own. However, in more serious cases, the doctor may treat it by reducing the air pressure in your chest via needle or tube.
Suspect a blood clot if you have sudden pain and breathing troubles.A pulmonary embolism (blood clot in the lung, or PE) occurs when a clot blocks blood flow from the heart to one of your lungs. These clots often travel up from your legs (a condition known as deep vein thrombosis or DVT) and are more likely after sitting for long periods of time.
- Symptoms include sudden-onset shortness of breath and chest and back pain, and can also include a bloody cough, profuse sweating, lightheadedness, and bluish lips.
- PE requires immediate medical care, which may include clot-busting drugs or surgery.
Get tested for pneumonia if you have signs of infection.Pneumonia is the name given to any type of lung infection, whether it’s caused by a virus, bacteria, or fungus. No matter the cause, you’ll usually experience both breathing troubles—like shortness of breath or chest pain—as well as infection symptoms—like fever, chills, nausea, and fatigue.
- Your doctor will start your pneumonia diagnosis by listening to your lungs via a stethoscope, then they will take a chest x-ray. Next, they'll likely do a blood test to look for an infection.
- Although it can be life-threatening and require hospitalization, most cases of pneumonia can be treated with medication.
Undergo tests for COPD for slowly worsening symptoms.Chronic obstructive pulmonary disease (COPD) mimics many of the symptoms of asthma, but usually occurs in older people and worsens over time. People who smoke, experienced second-hand smoke, were exposed long-term to chemicals or particulates, or have a genetic predisposition are more likely to get COPD.
- Signs of COPD include chronic shortness of breath, wheezing, coughing (with or without excessive mucus), and chest tightness.
- Don't assume that a COPD diagnosis means your quality of life is ruined. While COPD isn't reversible, many people respond well to treatments like inhalers, nebulizer treatments, medication, new breathing techniques, and portable supplemental oxygen.
Evaluate your risk factors for lung cancer.This is the number-one cancer killer in the U.S. and many other nations around the world, and a high percentage of cases are linked to smoking. Especially if you smoke, used to smoke, or have a family history of lung cancer, take note of symptoms like shortness of breath, wheezing, chest pain, a bloody cough, reduced appetite or weight loss, and swelling of the face or neck.
- X-rays, mucus exams, and biopsies (tissue samples) are often used to diagnose lung cancer, and treatments can include surgery, radiation, chemotherapy, and a range of other possibilities.
- Even if you're a longtime smoker, don't assume lung cancer is inevitable. No matter how long you've been smoking, quitting as soon as possible will reduce your risk of lung cancer. If you live in the U.S., you can call 1-800-QUIT-NOW for advice and support.
Undergoing Standard Diagnostic Tests
Visit your doctor for a physical evaluation.Diagnosing a lung problem usually begins with your doctor using a stethoscope to listen to your chest and back as you breathe deeply. They’ll also listen without the stethoscope for evidence of wheezing or other abnormal breathing sounds.
- During the physical exam, they’ll also ask things like how long you’ve had symptoms, whether you’re coughing up mucus and/or blood, and so on.
- Be as detailed and honest as you can when describing your symptoms and health history—for instance, whether and how much you smoke. Write notes for yourself before the visit if you’re worried you’ll forget something.
Undergo chest x-rays and other diagnostic imaging.X-rays of the back, front, and side(s) of the chest can identify many types of lung disorders, including pneumonia, COPD, tumors, and pneumothorax. If more detailed imaging is needed, your doctor may advise other options as well, including:
- CT scans, which are essentially an enhanced series of x-rays.
- an MRI, which can provide finer imaging detail in many cases.
- a PET scan, especially if cancer is suspected.
Take a pulmonary function test.During this simple test, you’ll exhale as forcefully and quickly as possible into a tube connected to a machine. The device will quickly analyze the volume, timing, and other details of your breathing.
- You may also be asked to undergo more specialized versions of this test, where more detailed and specific elements of your breathing are analyzed.
Let the doctor do a bronchoscopy.During this procedure, a flexible tube with a camera at the end is inserted through your nostril and down your airway. This allows the doctor to more clearly see any damage, blockages, fluid or mucus buildup, and so on.
- In some cases, bronchoscopy can also be used to take tissue samples (biopsy), remove blockages, or implant medication.
- This procedure may sound uncomfortable or even scary, but don't worry. You’ll be given a sedative beforehand, or may be placed under general anesthesia.
Consider undergoing a thoracoscopy, if needed.Your doctor may decide to do a thoracoscopy to help diagnose serious conditions, such as cancer. This procedure is similar to a bronchoscopy, except the flexible tube with a camera is inserted through small incisions made in your chest. This process intentionally deflates your lung, meaning it will have to be reinflated with a chest tube after the exam. This test, therefore, requires hospitalization.
- Since this procedure is viewed as a minor surgery, you'll receive a local anesthesia to minimize your pain and discomfort. Afterwards, plan to spend 2-3 weeks taking it easy, as you'll need to care for stitches or staples over the insertion spot. You will likely return to your normal routine after 2 weeks.
Recognizing Signs of Lung Problems
Take note of chronic coughing for more than a month.It’s typical to have a nagging cough that lasts a week or two if you’ve caught a cold. But if the coughing is persistent and lasts for a month or more, go see your doctor to check for potential lung issues.
- Even if your cough turns out not to be due to a lung problem, your doctor may be able to diagnose and treat its cause.
Keep track of unexplained shortness of breath.If you can’t catch your breath within a few minutes after moderate physical activity, or at any time when you haven’t been physically active, don’t brush it off as “getting old” or “being out of shape.” Unexplained shortness of breath is a common symptom of nearly every major lung disorder, including COPD, pneumonia, and lung cancer.
Don’t ignore chronic mucus production.If you’ve been coughing up mucus for a month, it almost certainly isn’t due to the common cold or a similar condition. Make an appointment with your doctor so you can be examined.
- If you see blood in the mucus at any time, contact your doctor.
- You should also notice if your mucus has color. For example, green or bright yellow mucus could be a sign that you have an infection.
Mention chronic wheezing or loud breathing.Wheezing can occur suddenly, especially if you have asthma, COPD, a collapsed lung, or lung cancer. Along with or instead of wheezing, you may hear unusual gurgling or crackling sounds while breathing. In any case, contact your doctor.
- Snoring isn’t usually caused by a lung disorder, but it can be a sign of a dangerous condition (sleep apnea) and should be diagnosed.
Take action if you’ve had mild chest pain for 2-3 weeks.Chest pain can be a symptom of everything from heartburn to a bruised rib to a heart attack, so you might not immediately identify it with a lung problem. However, if you have a dull chest pain that lasts for 2-3 weeks or more, see your doctor and ask whether the pain may be lung-related.
- If you have severe chest pain, get medical help right away.
Seek emergency help if you’re coughing up blood.If you cough up a thick red, black, or coffee ground-looking substance, then you should seek emergency medical attention, as this is a life-threatening situation. No matter what the blood you’re coughing up looks like, though, get in touch with your doctor right away.
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