Atelectasis and scarring are two conditions of the lungs that make it difficult to breath. Atelectasis, a complete or partial collapse of a lung, can be reversed; scars in the lung cannot. Atelectasis can lead to lung scarring and, in some cases, scar tissues can escalate into interstitial lung disease.
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Atelectasis is caused by a blockage of one or more of the air tubes that lead to the lungs. This blockage may come from inside or outside of the air tube. For example, a plug of mucus, a tumor or an inhaled foreign object may block the tube from the inside, while a tumor, pressure from air or fluid in the chest cavity or enlarged lymph nodes could press on the tubes from the outside. In addition, conditions that decrease deep breathing, such as large doses of sedatives, or conditions that suppress the ability to cough can also cause atelectasis.
Scarring of the lungs can occur for a variety a reasons, and unlike atelectasis, it is not necessarily the result of a blockage. An injury to your lungs can trigger an abnormal healing response, resulting in the production of excess scar tissue. This excess scar tissue interferes with lung function. Lung injuries leading to scar tissue development can also include long-term exposure to toxins, bacterial or fungal growth, as well as viral and parasitic infections . Radiation and chemotherapy drugs, as well as some drugs used to treat heart arrhythmias, psychiatric drugs and some antibiotics can also damage lungs, leading to scar tissue formation. Some conditions do not attack the lungs directly, but nevertheless due to their effects on tissues throughout the body, lead to scar formation. These include lupus, scleroderma, rheumatoid arthritis, dermatomyositis, polymyositis, Sjogren's syndrome and sarcoidosis.
Symptoms of atelectasis include difficulty breathing, rapid shallow breathing, chest pain, cough and low-grade fever. Often the only symptom experienced is shortness of breath, although there may be no obvious signs or symptoms at all.
Symptoms of lung scarring are similar and include a feeling of breathlessness, especially during or after physical activity, a dry cough, fever, chills, wheezing, chest pain, night sweats, weight loss, decreased energy level and fingers that curve over the tops of your fingertips. These symptoms become progressively worse. When the condition is severe, you may also develop low blood oxygen levels, high blood pressure, right-sided heart failure and respiratory failure.
The specific treatment for atelectasis depends upon the cause, although the ultimate goal remains the same: removal of whatever is causing the constricted air tube so that the collapsed lung can re-expand. If fluid is compressing the lung, the treatment would be to remove the fluid. If mucus is blocking the tube, loosening the mucus with percussion or clapping on the chest is usually attempted. Obstructions can sometimes be removed by bronchoscopy. Tumors can be removed by surgery, radiation, laser or chemotherapy. Aerosolized respiratory treatments, inhaled medications, can also be used to open the airway.
Unfortunately, the formation of scars on the lungs are not reversible. However, a small scar, or a small number of scars, are often well-tolerated as long as the underlying condition causing the scars is treated or does not progress.
Atelectasis in a small area of the lung, as well as small lung scars, are usually not life-threatening. Lungs are resilient; a collapsed lung usually reinflates once the obstruction is removed. However, some scarring or damage may remain. If small enough, it will not cause further problems.
Atelectasis can be prevented by encouraging movement and deep breathing, particularly for patients who are bedridden for long periods of time or who have been under anesthesia, as well as keeping choking hazards away from small children. Smoking increases your risk for atelectasis, particularly before surgery. Decreasing your risks of developing atelectasis as well as any other lung injury also decreases your risk for lung scarring.