ConditionLungs & breathing
Respiratory Conditions: An Overview of Lung and Breathing Disorders
Respiratory conditions are diseases that affect the airways, lungs, the blood vessels of the lungs, the lining around the lungs, or the control of breathing. They range from short-lived infections such as bronchitis to long-term diseases such as asthma, COPD and pulmonary fibrosis. Common symptoms are cough, shortness of breath, wheezing, chest tightness and mucus. Breathing tests, imaging and blood oxygen measurements help tell them apart, and many can be controlled well with the right treatment.
Also called: Respiratory system disorders, lung diseases, breathing conditions, pulmonary disease, lung conditions
At a glance
- What they are
- Conditions affecting breathing, from the nose and throat to the smallest air sacs.
- Main groups
- Obstructive, restrictive (interstitial), infectious, vascular, pleural, cancer and sleep-related.
- Common symptoms
- Cough, breathlessness, wheeze, chest tightness, mucus and fatigue.
- Key tests
- Pulse oximetry, spirometry, chest X-ray or CT, and sometimes sleep studies or bronchoscopy.
- Prevention
- Not smoking or vaping, vaccines, clean air and early treatment.
When to get help
Call 911 or go to the ER
- Severe breathlessness at rest, struggling to breathe, or unable to speak in full sentences
- Blue or gray lips or fingertips, or confusion and drowsiness
- Sudden sharp chest pain with breathlessness, especially after travel, surgery or with a swollen leg (possible blood clot in the lung)
- Coughing up more than a few teaspoons of blood
- Noisy high-pitched breathing (stridor) or swelling of the throat or tongue
See a doctor within a day or two
- Fever with breathlessness or chest pain when breathing
- A known lung condition that is suddenly worse and not responding to your usual treatment or action plan
- Ankle swelling with increasing breathlessness
Book a routine appointment
- A cough lasting more than 3 weeks, or more than 8 weeks in adults with no improvement
- Breathlessness that has slowly increased over months
- Wheezing or chest tightness with exercise or at night
- Loud snoring with pauses in breathing and daytime sleepiness
- Weight loss, night sweats or a change in a long-term cough in a smoker
Types of respiratory conditions
Obstructive airway diseases
Air has trouble getting out of the lungs because the airways are narrowed.
- Asthma: variable, reversible airway narrowing with wheeze and cough
- COPD: chronic bronchitis and emphysema, mostly from smoking, with persistent breathlessness
- Bronchiectasis: widened, damaged airways with daily mucus and repeated infections
- Cystic fibrosis: an inherited condition causing thick mucus in the lungs and gut
Restrictive and interstitial lung diseases
The lungs cannot fully expand, often because lung tissue is stiff or scarred.
- Interstitial lung disease, including idiopathic pulmonary fibrosis, sarcoidosis and disease linked to rheumatoid arthritis or scleroderma
- Occupational lung disease: asbestosis, silicosis
- Chest wall and muscle problems: severe scoliosis, obesity, neuromuscular diseases
Infections
- colds and sinusitis (upper respiratory)
- acute bronchitis, pneumonia, bronchiolitis, influenza, COVID-19 and whooping cough
- tuberculosis and fungal infections
See lung infections for how these differ.
Pulmonary vascular diseases
- Pulmonary embolism: a blood clot blocking lung arteries
- Pulmonary hypertension: high pressure in the lung arteries, causing breathlessness and right heart strain
- Pulmonary edema: fluid in the lungs, often from heart failure
Pleural diseases
- Pleural effusion: fluid around the lungs
- Pneumothorax: collapsed lung from air in the chest cavity
- Pleurisy: inflamed lining causing sharp pain with breathing
- Mesothelioma: cancer of the lining, linked to asbestos
Lung cancer
Lung cancer is the leading cause of cancer death in the US. Smoking causes most cases, but it also occurs in people who never smoked. Annual low-dose CT screening is recommended for adults aged 50 to 80 with a significant smoking history.
Sleep-related breathing disorders
Sleep apnea causes repeated pauses in breathing during sleep, with snoring and daytime sleepiness.
Upper airway disorders
Vocal cord dysfunction, laryngeal problems and airway narrowing can cause noisy breathing and breathlessness that mimic asthma.
Obstructive vs restrictive: how breathing tests tell them apart
| Obstructive disease | Restrictive disease | |
|---|---|---|
| Problem | Narrowed airways slow airflow out | Lungs cannot expand fully |
| Examples | Asthma, COPD, bronchiectasis | Pulmonary fibrosis, chest wall disease, obesity |
| FEV1/FVC ratio | Reduced (below about 0.70) | Normal or high |
| Total lung capacity | Normal or increased | Reduced |
| Response to bronchodilator | Often improves in asthma | Little change |
Symptoms that point to specific conditions
| Pattern | Possible conditions |
|---|---|
| Wheeze and cough that come and go, worse at night or with exercise | Asthma |
| Progressive breathlessness and daily cough in a smoker over 40 | COPD |
| Daily large volumes of mucus and frequent infections | Bronchiectasis |
| Dry cough and breathlessness with crackles in the lungs | Interstitial lung disease |
| Sudden breathlessness and sharp chest pain | Pulmonary embolism, pneumothorax |
| Fever, cough and breathlessness over days | Pneumonia |
| Snoring, pauses in breathing, daytime sleepiness | Sleep apnea |
How respiratory conditions are diagnosed
- History and examination, including smoking, work exposures, travel and family history
- Pulse oximetry: measures blood oxygen
- Spirometry and full pulmonary function tests: measure airflow and lung volumes
- Peak flow monitoring for asthma
- Chest X-ray and CT scan
- Blood tests, including arterial blood gases in severe illness
- Sputum tests for infection
- Sleep studies for sleep apnea
- Bronchoscopy: a camera into the airways for biopsies or samples
- Echocardiogram for pulmonary hypertension
- CT pulmonary angiography for suspected clots
Treatment approaches
- Inhalers: bronchodilators and inhaled steroids for asthma and COPD
- Antibiotics and antivirals for infections
- Oxygen therapy for low oxygen levels
- Pulmonary rehabilitation: exercise and education programs that improve breathlessness and quality of life in chronic lung disease
- Anticoagulants for blood clots
- Antifibrotic medicines for some interstitial lung diseases
- CPAP for sleep apnea
- Surgery and procedures: draining fluid, lung volume reduction, cancer surgery and transplantation in advanced disease
Prevention and lung health
- do not smoke or vape, and avoid secondhand smoke
- stay up to date with flu, COVID-19, pneumococcal, RSV and whooping cough vaccines as recommended
- reduce exposure to air pollution, wood smoke and workplace dusts and fumes
- test homes for radon, the second leading cause of lung cancer in the US
- stay active and maintain a healthy weight
Frequently asked questions
What are the most common respiratory conditions?
The most common are colds and other respiratory infections, asthma, COPD, pneumonia, allergic rhinitis and sleep apnea. Lung cancer, interstitial lung disease, bronchiectasis and pulmonary embolism are less common but serious.
What is the difference between obstructive and restrictive lung disease?
In obstructive lung disease, such as asthma and COPD, narrowed airways make it hard to breathe out fully. In restrictive lung disease, such as pulmonary fibrosis, the lungs cannot expand fully, reducing lung volume. Breathing tests distinguish them.
What are the warning signs of a lung problem?
Warning signs include a cough lasting more than 3 weeks, breathlessness that is new or getting worse, wheezing, chest pain with breathing, coughing up blood, unexplained weight loss and repeated chest infections. Severe breathlessness or blue lips need emergency care.
How are lungs tested?
Common tests include pulse oximetry, spirometry and full lung function tests, chest X-rays and CT scans, blood tests and sputum samples. Sleep studies, bronchoscopy and heart ultrasound are used for specific conditions.
Can lung damage be reversed?
Some can. Infections usually heal fully, and asthma-related narrowing reverses with treatment. Scarring in pulmonary fibrosis and emphysema in COPD are mostly permanent, but treatment, pulmonary rehabilitation and stopping smoking slow progression and improve symptoms.
Sources
This guide was written from current patient and clinical guidance, including:
- American Lung Association: Lung disease lookup
- National Heart, Lung, and Blood Institute: Lung diseases
- American Thoracic Society: Patient education series
- World Health Organization: Chronic respiratory diseases
- CDC: Chronic obstructive pulmonary disease
- Global Initiative for Chronic Obstructive Lung Disease (GOLD): Global strategy report