The scenario illustrates the case of a 45-year-old patient experiencing an acute exacerbation of COPD. This condition can last for a few days and is often related to infections due to a sudden worsening of COPD respiratory symptoms. This paper explores cardiovascular and cardiopulmonary processes and racial or ethnic variables pertaining to the case.
The combination of symptoms in the case stems from cardiovascular and cardiopulmonary pathophysiological processes. As for cardiopulmonary processes, in COPD, the breakdown of lung tissue resulting in suboptimal airflow, the alteration of lung function, increased oxidative stress, and increases in cough reflex sensitivity contribute to increased hypoventilation, severe uncontrollable cough, and shortness of breath (McCance & Huether, 2019; Radovanovic et al., 2018). Also, lung hyperinflation, due to which the lungs force the diaphragm downward, can lead to diaphragm flattening, as CXR revealed in the case. In COPD attacks, flu-like symptoms (fever) and changes in sputum color (yellow or green sputum) or thickness are attributed to high bacterial load or viral infections, but exposure to environmental pollutants can also trigger COPD exacerbations (Stolz et al., 2019). Regarding cardiovascular processes and their interactions with cardiopulmonary ones, emphysema found in COPD patients can cause increased pressure in the arteries between the lungs and the heart, resulting in pulmonary hypertension and low blood oxygen levels that increase the workload on the heart (Morgan et al., 2018). This can also contribute to the shortness of breath experienced by the patient.
The role of racial/ethnic variables in physiological functioning during COPD exacerbations remains relatively unexplored. However, there are suggestions that cardiovascular symptoms are more prevalent in COPD patients with high BMIs and a small airway form of COPD, both of which are more typical for races other than Asian (Morgan et al., 2018). Also, comparisons between Japanese and European/American patients with COPD attacks suggest that the former are less likely to manifest CVD comorbidities (Morgan et al., 2018). Thus, the prevalence of cardiovascular exacerbations in COPD attacks varies between races.
In summary, the patient’s symptoms are indicative of diverse pathophysiological processes, including airway obstruction and pulmonary hyperinflation that may affect the heart. Interactions between cardiopulmonary and cardiovascular processes influence general well-being and shortness of breath. Cardiovascular symptoms in COPD attacks can be more pronounced in non-Asians.
References
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Mosby/Elsevier.
Morgan, A. D., Zakeri, R., & Quint, J. K. (2018). Defining the relationship between COPD and CVD: What are the implications for clinical practice?Therapeutic Advances in Respiratory Disease, 12, 1-16. Web.
Radovanovic, D., Pecchiari, M., Pirracchio, F., Zilianti, C., D’Angelo, E., & Santus, P. (2018). Plethysmographic loops: A window on the lung pathophysiology of COPD patients. Frontiers in Physiology, 9, 1-8. Web.
Stolz, D., Papakonstantinou, E., Grize, L., Schilter, D., Strobel, W., Louis, R., Schindler, C., Hirsch, H. H., & Tamm, M. (2019). Time-course of upper respiratory tract viral infection and COPD exacerbation. European Respiratory Journal, 54(4), 1-16. Web.