Pneumonia: symptoms, diagnosis and treatment

What is pneumonia?

Pneumonia is an infection in one or both lung. It can be caused by fungi, bacteria, or viruses. Pneumonia causes inflammation in your lung’s air sacs, or alveoli. The alveoli fill with fluid or pus, making it difficult to breathe.

Symptoms of pneumonia can range from mild to life-threatening. The severity of your pneumonia usually depends on:

• the cause of your inflammation
• the type of organism causing your infection
• your age
• your general health

Keep reading to learn about what causes pneumonia as well as its symptoms. You should call your doctor if you have any concerns. Severe pneumonia is a medical emergency.

What are the symptoms of pneumonia?

The general symptoms of bacterial pneumonia can develop quickly and may include:

• chest pain
• shaking chills
• fever
• dry cough
• wheezing
• muscle aches
• nausea
• vomiting
• rapid breathing
• rapid heartbeat
• difficulty breathing

                      

Some symptoms may indicate a medical emergency. You should seek immediate medical attention if you have any of these symptoms:

• skin with bluish tone (from lack of oxygen)
• blood in sputum (coughed-up mucus)
• labored breathing
• high fever (102.5°F or higher)
• confusion
• rapid heartbeat

When to call your doctor?

 

Some symptoms may indicate a medical emergency. You should seek immediate medical attention if you have any of these symptoms:

• skin with bluish tone (from lack of oxygen)
• blood in sputum (coughed up mucus)
• labored breathing
• high fever (102.5°F or higher)
• confusion
• rapid heartbeat

Types and causes of pneumonia

There are five major types of pneumonia. They are:

Bacterial Pneumonia

Bacterial pneumonia can affect anyone at any age. It can develop on its own or after a serious cold or flu. The most common cause of bacterial pneumonia is Streptococcus pneumoniae. Bacterial pneumonia can also be caused by Chlamydophila pneumonia or Legionella pneumophila. Pneumocystis jiroveci pneumonia is sometimes seen in those who have weak immune systems due to illnesses like AIDS or cancer.

Viral Pneumonia

In most cases, respiratory viruses can cause pneumonia, especially in young children and the elderly. Pneumonia is usually not serious and lasts a short time. However, the flu virus can cause viral pneumonia to be severe or fatal. It’s especially harmful to pregnant women or individuals with heart or lung issues. Invading bacteria can cause complications with viral pneumonia.

Mycoplasma Pneumonia

Mycoplasma organisms are not viruses or bacteria, but they have traits common to both. They are the smallest agents of disease that affect humans. Mycoplasmas generally cause mild cases of pneumonia, most often in older children and young adults.

Other Types of Pneumonia

Many additional types of pneumonia affect immune-compromised individuals. Tuberculosis and Pneumocystis carinii pneumonia (PCP) generally affect people with suppressed immune systems, such as those who have AIDS. In fact, PCP can be one of the first signs of illness in people with AIDS.

Less common types of pneumonia can also be serious. Pneumonia can be caused by inhaling food, dust, liquid, or gas, as well as by various fungi.

How is pneumonia diagnosed?

Pneumonia can be easily overlooked as the cause of an illness because it often resembles a cold or the flu. However, it usually lasts longer and symptoms seem more severe than these other conditions.

Detailed Patient History

To determine whether or not you have pneumonia, your doctors will usually inquire about your signs and symptoms. Questions they may ask include:

• What are your symptoms and when did they begin?
• What were your recent travels and activities?
• What was your recent exposure to animals?
• What was your recent exposure to individuals who are sick?
• What are your past and current medical issues?
• What medications are you currently taking?
• What is your smoking history?
• Have you recently had any vaccinations or illnesses?

Physical Exam

Crackling and bubbling sounds in the chest during inhalation are usually indicators of pneumonia. Wheezing may also be present. Your doctor may also have trouble hearing normal breathing sounds in different areas of your chest.

Diagnostic Tests

Chest X-rays can be used to determine if infection is present in your lungs. However, chest X-rays won’t show your type of pneumonia. Blood tests can provide a better picture of the type of pneumonia. Also, blood tests are necessary to see if the infection is in your bloodstream.

                            

Other Tests

The following are additional tests that may be required:

• A CT scan of the chest is similar to an X-ray, but the pictures provided by this method are highly detailed. This painless test provides a clear and precise picture of the chest and lungs.
• This sputum test involves examining the sputum (the mucus you cough up) to determine what type of pneumonia is present.
• If there is fluid apparent in the pleural space (the space between the tissue that covers the outside of your lungs and the inside of your chest cavity), a fluid sample can be taken to help determine if the pneumonia is bacterial or viral.
• A pulse oximetry test measures the level of oxygen blood saturation by attaching a small sensor to your finger. Pneumonia can prevent normal oxygenation of the blood.
• When antibiotics fail, a bronchoscopy can be used to view the airways inside the lungs to determine if blocked airways are contributing to the pneumonia.

How is pneumonia treated?

The type of treatment prescribed for pneumonia mostly depends on what type of pneumonia is present, as well as how severe it is. In many cases, pneumonia can be treated at home.

General Treatment

The typical treatment plan for pneumonia includes taking all prescribed medications and participating in follow-up care. A chest X-ray may be ordered to make sure your pneumonia has been successfully treated.

Treating Bacterial Pneumonia

Antibiotics are used to treat this type of pneumonia. Antibiotics should be taken as directed. If you stop taking the antibiotics before treatment is complete, the pneumonia may return. Most people will improve after one to three days of treatment.

Treating Viral Pneumonia

Antibiotics are useless if a virus is the cause of pneumonia. However, certain antiviral drugs can help treat the condition. Symptoms usually clear within one to three weeks.

                                      

HOME REMEDIES

Home remedies

Pneumonia must be treated by your doctor. The two most important things you can do to get better are to take any medications as prescribed and to get plenty of rest. However, there are some some things you can do at home to help treat your symptoms. These include:

• Drinking lots of fluid. This will help loosen up phlegm and keep you hydrated.
• Taking certain cough medicines. However, do not take anything without the approval of your doctor.
• Taking aspirin, nonsteroidal anti-inflammatory drugs (ibuprofen or naproxen), or acetaminophen to control fever or relieve pain.

Other natural remedies to treat your symptoms include the following:

• Drink broth-based soups or teas to sooth your throat.
• Suck on ice cubs, take cool showers, or drink chilled peppermint, thyme, or chamomile tea to help fever.
• Try a humidifier or breathing in moist, warm air to avoid dry throat irritation.
• Rid your home of inhalable irritants or allergens, such a cigarette smoke.
• Practice good hygiene like consistently washing your hands to prevent pneumonia from spreading.
• Improve your diet to boost immune system by avoiding inflammatory, allergenic, or highly-processed foods.
• Eat probiotic foods such as cultured yogurt or vegetables.

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Heart Attack: Symptoms, Diagnosis, and Treatments

What is a heart attack?

Myocardial infarction is another name for a heart attack.

Other terms used for a heart attack include myocardial infarction, cardiac infarction, and coronary thrombosis (Infarction refers to the process whereby an area of dead tissue is caused by a loss of blood supply).

According to the American Heart Association:

• During a heart attack, the heart muscle that loses its blood supply starts to suffer injury.
• How much damage occurs depends on the size of the area that is supplied by the blocked artery, as well as the length of time between injury and treatment.
• The damaged heart muscle heals by forming scar tissue. The healing process may take several weeks.
• Despite severe injury to a part of the heart, the rest of the organ carries on working.
• However, as part of the heart has been damaged, it will probably be weaker and will not pump as much blood as it used to.
• With the right treatment and lifestyle changes, further damage can be prevented or limited.

Symptoms of a heart attack

The following are signs and symptoms for diagnosing a heart attack:

• Chest discomfort, mild pain
• Coughing
• Nausea
• Vomiting
• Crushing chest pain
• Pressure tightness, pain, squeezing or aching in the chest or arms that spreads to the neck, jaw, or back
• Dizziness
• Dyspnea (shortness of breath)
• Face seems gray
• A feeling of terror that your life is coming to its end
• Feeling really awful (general feeling)
• Restlessness
• Feeling clammy and sweaty
• Shortness of breath       

                                      

The emergency services should be called immediately.

The pain of a heart attack is not alleviated by changing position; the pain is normally constant, but it may sometimes come and go. Patients describe the pain as one of pressure, like a clamp squeezing inside your chest. The pain can last from a few minutes to many hours.

Causes of a heart attack

The following are possible factors associated with increased risk of heart attack.

• Age: Risk increases when a man is over 45, and a woman is over 55.
• Angina: An illness where not enough oxygen reaches the heart, causing chest pain resembling a heart attack, but it resolves after taking medication. Angina raises the risk of a heart attack.
• High blood cholesterol levels: Increases the risk of developing blood clots in the arteries.
• Diabetes: People with diabetes have a higher risk of developing several diseases and conditions, many of them contribute to a higher risk of heart attack.
• Diet: Someone who consumes large quantities of, for example, saturated fats, will eventually have a higher risk of having a heart attack.
• Genes: You can inherit a higher risk of heart attack.
• Heart surgery: Patients who have had heart surgery have a higher risk.
• Hypertension (high blood pressure).
• Obesity, overweight.
• Physical inactivity: More active people have a lower risk.
• Previous heart attack: Anybody who has already had a heart attack is more likely to have another one, compared with people who have not.
• Smoking.
• HIV: People who are HIV positive have a 50 percent higher risk of heart attack.
• Work stress: Individuals with stressful jobs, or shift workers have an increased risk of heart attack.

                              

Diagnosis of heart attacks

Any doctor, nurse, or health care professional, will send a patient straight to hospital if they suspect they may have a heart attack. In hospital, several tests might be done:

• ECG (Electrocardiograph): Monitors the electrical activity of the heart muscles
• Cardiac enzyme tests: Blood tests detect enzymes produced during a heart attack
• Chest X-ray: To look for swelling of the heart

Treatments for a heart attack

The faster the heart attack patient can be treated, the more successful his/her treatment will be. These days, the majority of heart attacks can be treated effectively. It is crucial to remember that the patient's survival depends largely on how quickly they can be taken to hospital.

                             

                             

Treatments during a heart attack

CPR (cardio-pulmonary resuscitation)

Some heart attack patients stop breathing; they do not move or respond when spoken to or touched, they may also be coughing. If this is the case, CPR should be started straight away. This involves:

• Manual chest compressions - continuous chest compressions to the heart at about 100 beats per minute.
• Defibrillator - the defibrillator sends electric shocks across the patient's chest - the aim is to use electricity to shock the heart back into proper activity.
• Aspirin - often given to patients during a heart attack. Aspirin will help stop the clot in the artery from growing.
• Thrombolytics - these dissolve blood clots.
• Painkillers - morphine is sometimes injected into the patient to control the pain and reduce anxiety.

Treatments following a heart attack

Most patients will need several different medications after their heart attack. The aim being to prevent future heart attacks from occurring.

• Aspirin and other antiplatelets: Antiplatelets lower the chances of blood clotting
• Beta-blockers: Make the heart beat slower and with less force
• ACE (Angiotensin-converting enzyme) inhibitors: Ease the workload on the heart by opening up blood vessels and lowering blood pressure
• Statins: Lower blood cholesterol levels
• Procedures after a heart attack: If the patient's heart has been severely damaged they may need a procedure. The most common two are:
  • Angioplasty: This procedure opens up the coronary artery. A small wire enters the artery and is pushed until it reaches the clot in the coronary artery. A small balloon at the end of the wire is placed at the narrowest part of the artery and inflated, squashing the clot. A flexible metal mesh, called a stent, is then placed there to keep the artery open.
  • CABG (Coronary artery bypass graft): The damaged blood vessel is bypassed with grafts taken from blood vessels elsewhere in the body. The bypass effectively goes around the blocked area of the artery, allowing blood to pass through into the heart muscle.

Recovery after a heart attack

Resting after a heart attack is essential.

Recovering from a heart attack can be a slow and gradual process.

It may involve liaising with various types of health care professionals, including doctors, dietitians, nurses, physiotherapists, pharmacists, and personal trainers.

• Physical activity: It is vital that a recovering heart attack patient tries to stay active. However, it is important that any exercise program is devised by a specialist.
• Going back to work: When a heart attack patient can go back to work depends on various factors including the severity of the heart attack and the type of job. It is vital that people do not rush back to work.
• Depression: About 20 percent of heart attack patients go on to have a major episode of depression not long afterward. Heart attack patients who feel depressed or anxious should tell their doctors immediately.
• Driving: Experts advise that a person refrains from driving for at least 4 weeks after a heart attack.
• Erectile dysfunction: Approximately one third of all men who have a heart attack have problems getting, or sustaining, an erection. Experts say that sexual activity does not raise a person's risk of having another heart attack. It is important that men with erectile dysfunction talk to their doctors - in the majority of cases, medications are effective at restoring function.

Complications after a heart attack

There are two types of complications, those that occur pretty much straight away, and those that happen later.

Immediate complications

• Arrhythmias - the heart beats irregularly, either too fast or too slowly. Most patients, with time, will return to regular rhythms.
• Cardiogenic shock - the patient's blood pressure suddenly drops dangerously. The heart cannot supply enough blood for the body to work adequately.
• Hypoxemia - levels of blood oxygen become too low.
• Pulmonary edema - fluid accumulation in and around the lungs.
• DVT (deep vein thrombosis) - the deep veins of the legs and pelvis develop blood clots which either block or interrupt the flow of blood in the vein.
• Myocardial rupture - the heart attack damages the wall of the heart. This increases the risk of a heart wall rupture.
• Ventricular aneurysm - one of the chambers (ventricles) of the heart forms a bulge.

Complications that can occur later

• Aneurysm - scar tissue builds up on the damaged heart wall. This leads to blood clots, low blood pressure, and abnormal heart rhythms.
• Angina - Not enough oxygen is reaching the heart. Symptoms may be similar to those of a heart attack.
• Congestive heart failure - the heart can only beat very weakly. The patient feels exhausted and breathless.
• Edema - fluid accumulates in the ankles and legs (they swell).
• Loss of erectile function - erectile dysfunction is generally caused by a vascular problem. However, it can also be the result of depression.
• Loss of libido - this is especially the case with men.
• Pericarditis - the lining of the heart becomes inflamed, causing serious chest pain.

Patients who comply with their doctor's instructions have a much better chance of recovery than those who don't. It is important that the doctor monitors a heart attack patient for several months afterwards.

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