Chest/Pulmonology

Pulmonology is a medical specialty that deals with diseases involving the respiratory tract. It is also known as respirology, respiratory medicine, or chest medicine in some countries and areas.

Pulmonology is considered a branch of internal medicine, and is related to intensive care medicine. Pulmonology often involves managing patients who need life support and mechanical ventilation. Pulmonologists are specially trained in diseases and conditions of the chest, particularly pneumonia, asthma, tuberculosis, emphysema, and complicated chest infections.

Diagnosis

The pulmonologist begins the diagnostic process with a general review focusing on:

• Hereditary diseases affecting the lungs (cystic fibrosis, alpha 1-antitrypsin deficiency)
• Exposure to toxicants (tobacco smoke, asbestos, exhaust fumes, coal mining fumes, e-cigarette aerosol)
• Exposure to infectious agents (certain types of birds, malt processing)
• An autoimmune diathesis that might predispose to certain conditions (pulmonary fibrosis, pulmonary hypertension)

Physical diagnostics are as important as in other fields of medicine.

• Inspection of the hands for signs of cyanosis or clubbing, chest wall, and respiratory rate.
• Palpation of the cervical lymph nodes, trachea and chest wall movement.
• Percussion of the lung fields for dullness or hyper-resonance.
• Auscultation (with a stethoscope) of the lung fields for diminished or unusual breath sounds.
  • Rales or rhonchi heard over lung fields with a stethoscope.

As many heart diseases can give pulmonary signs, a thorough cardiac investigation is usually included.