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Saturday 27 November 2021
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Common Chest Conditions

Chronic Obstructive Pulmonary Disease (COPD) 

Everyone with chronic bronchitis, most patients with emphysema and some people with chronic asthma have a chest condition described as ‘chronic obstructive pulmonary disease’.


Chronic bronchitis

This is a disease where the tubes in the lungs become irritated or inflamed. This is usually caused by smoking. The irritation can make the lungs produce a lot of phlegm. This in turn causes the tubes to become narrower and can partially block the airways causing coughing, breathlessness and wheezing.



With emphysema, the air sacs in the lungs are damaged. Again the main cause is smoking. With damaged air sacs, the oxygen cannot pass into the blood stream as it should. This means you have to breathe faster and deeper to get enough oxygen which makes exercise especially hard. With severe emphysema, you can be out of breath even when sitting still. In many cases, chronic bronchitis and emphysema develop together.


Chronic asthma

Some people with chronic asthma are also described as having COPD. This is because their condition causes irreversible obstruction of the airways due to inflammation and possibly phlegm. They may also suffer a cough and wheeze but usually more at night.


Pleural plaques

Pleural plaques are areas of thickening of the lining between the lung and chest wall. The plaques themselves are harmless - they do not cause any symptoms. However, in most cases they mean that you have been exposed to asbestos either in your work or occasionally in your home at some time in the past.


On average, the plaques appear in a chest x-ray about 20-50 years after a person has first been exposed to asbestos.


The plaques are not, in themselves, of any significance but they suggest that a person has been exposed to asbestos and may be at risk of other asbestos-related lung diseases such as mesothelioma (a tumour of the lining of the lungs) or asbestosis (a type of fibrosis or stiffening of the lungs) or occasionally lung cancer (especially in smokers).


Although these diseases can be serious, the risk of getting them is small. Asbestosis is very uncommon nowadays due to improved working conditions in recent years.


The main risk factor for lung cancer is cigarette smoking and many experts believe that the risk of lung cancer is very slight in patients with pleural plaques but no evidence of asbestosis. If you smoke you have a one in five chance of getting lung cancer over your lifetime. This may increase to about one in four if you also have pleural plaques. The risk of mesothelioma is very low. It ranges from about 0.5 to two cases per thousand people with plaques per year. A typical person with plaques diagnosed when aged about 55 would have a lifetime risk of mesothelioma of 1% to 4%. In other words the chances of NOT getting a mesothelioma in that person’s lifetime would be 96-99%.