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Five Reasons To See a Pulmonologist

May 13, 2024
by Serena Crawford

A patient may be referred to a pulmonologist for shortness of breath, recurrent chest infections, or excessive sleepiness during the day, among other reasons.

More than 34 million people in the U.S. live with chronic lung disease, according to estimates from the American Lung Association, and for many, breathing is difficult. Finding the right specialist can help patients address respiratory conditions that impact day-to-day living.

A pulmonologist is a physician who specializes in lung-related issues. Pulmonologists diagnose and treat various conditions, including asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis, pulmonary fibrosis, sarcoidosis, lung cancer, cystic fibrosis, pulmonary vascular disease, and obstructive sleep apnea. They evaluate and identify the causes of shortness of breath and persistent cough.

The Section of Pulmonary, Critical Care, and Sleep Medicine in the Yale School of Medicine Department of Internal Medicine has world-renowned experts in every subspecialty of respiratory medicine who use the latest guidelines and research to help patients manage a broad range of lung conditions.

Following are five examples of when health care professionals may consider referring a patient to a pulmonologist:

1. If a patient has ongoing shortness of breath.

Geoffrey Chupp, MD, professor of medicine and director of the Yale Center for Asthma and Airways Disease, emphasizes the importance of properly determining the cause of breathing difficulties. “Shortness of breath has many causes and often hinders a person’s ability to live a normal life and exercise,” he said. “The condition can be a sign of asthma, COPD, long COVID, or pulmonary hypertension, and is also a common symptom associated with cardiac issues, blood clots in the lung, anemia, and deconditioning.” A thorough evaluation that includes a physical exam, lung function testing, blood work, and imaging is often required to identify the cause, he added.

2. If a patient has recurrent chest infections or a persistent cough.

“Patients experiencing recurrent chest infections or chronic cough may have underlying lung tissue abnormalities that predispose them to these symptoms,” said Ashley Losier, MD, assistant professor of medicine and director of the Yale Bronchiectasis and NTM Infections Program. “A pulmonary expert can provide evaluation and management.” Losier and her colleagues counsel patients regarding strategies to treat chronic respiratory tract infections, including one caused by nontuberculous mycobacteria.

3. If an imaging test, such as a chest X-ray or CT scan, detects abnormalities in the lungs.

Sometimes, imaging tests find spots on the lungs called lung nodules. These nodules are often benign scars, but sometimes they indicate the development of a lung disease, a chronic infection, or cancer. Evaluation by a pulmonologist can help determine the cause.

Patients diagnosed with lung cancer benefit from significant advancements that have been made over the past two decades. “Lung cancer screening is now recommended for many individuals with a history of smoking,” said Lynn Tanoue, MD, MBA, professor of medicine and director of the Lung Cancer Screening Program at Yale. “By detecting lung cancer early, we can save many lives.”

4. If a patient has excessive sleepiness during the day or loud snoring at night, possible indications of a sleep disorder.

Sleep-disordered breathing, such as obstructive sleep apnea, can negatively impact cardiovascular and metabolic health, according to Klar Yaggi, MD, MPH, professor of medicine, who leads the Yale Sleep Medicine Program. Pulmonologists can diagnose, evaluate, and treat sleep problems, helping to improve a patient’s health, well-being, and quality of life.

5. Patients with occluded or blocked blood vessels in the lung may need to see a pulmonologist for specialized care.

Pulmonologists can evaluate short- and long-term conditions caused by pulmonary embolism, says Akhil Khosla, MD, assistant professor of medicine and director of Yale New Haven Health’s Pulmonary Embolism Response Team. “Pulmonologists play a key role in assessing, treating, and managing the care of patients with post-pulmonary embolism impairment,” he said. “This condition can be debilitating and progressive, leading to higher rates of illness and death.”

Patients with pulmonary symptoms who are referred to Yale’s nationally ranked multidisciplinary pulmonary center receive important care, including diagnostic tests, procedures, and treatments informed by the latest cutting-edge research, according to Naftali Kaminski, MD, Boehringer Ingelheim Pharmaceuticals, Inc. Professor of Medicine and chief of Yale-PCCSM. “More importantly, our experts establish a caring relationship with each patient and communicate promptly with referring physicians to ensure the best possible outcomes,” he said.

Other Yale-PCCSM programs include the Adult Cystic Fibrosis Program, Chronic Obstructive Pulmonary Disease (COPD) Program, Chronic Pulmonary Infection Research and Treatment Program, Comprehensive Pulmonary Medicine Program, Pulmonary Vascular Diseases Program, Tuberculosis Program, and Yale Interstitial Lung Disease Center of Excellence, housed at the Winchester Center for Lung Disease, in North Haven.

The Section of Pulmonary, Critical Care and Sleep Medicine is one of the eleven sections within Yale School of Medicine’s Department of Internal Medicine. To learn more about Yale-PCCSM, visit PCCSM's website, or follow them on Facebook and Twitter.

Submitted by Serena Crawford on May 10, 2024