Thoracic Surgery | Chest Diseases

Thoracic Surgery | Chest Diseases

Sometimes known as “Respiratory Medicine” or “Chest Medicine” it involves the study and treatment of the diseases that involve the lungs, the respiratory organs, and chest.

Diagnostic Facilities in Thoracic Department

The Thoracic Medicine Department at Avicenna Hospital has the facilities and expertise to diagnose, investigate and treat almost all of the common thoracic diseases, including Pneumonia Asthma, Chronic Obstructive Pulmonary Disease (COPD), unexplained shortness of breath and unexplained cough, and other lung infections.

A pulmonologist uses procedures such as spirometry, blood tests, X-rays, and bronchoscopy to diagnose chronic lung disease. Moreover, The lung specialist may also ask you to repeat these tests to confirm the results, even if you have already performed them. In addition, you may require other tests include:

  • CT and MRI scan
  • PET Scanning
  • Bronchoscopy examinations
  • X-rays
  • Thoracoscopy
  • Endobronchial ultrasound (EBUS)
  • Pleural membrane biopsy
  • Lung function tests and oxygen assessments
  • Chronic cough examination
  • Allergy tests (Skin prick test)
  • Thoracentesis
  • Overnight oximetry

What are Thoracic Diseases?

This department examines and treats almost all of the common thoracic diseases, including:

  • Lung infections: pneumonia, acute bronchitis, tuberculosis, etc.
  • Chronic diseases affecting the airways: Asthma, chronic obstructive pulmonary disease, chronic bronchitis,
  • Lung diseases associated with smoking, bronchiectasis, emphysema, Lung fibrosis, etc.
  • Lung Cancer and tumors
  • Interstitial lung disease: Pulmonary sarcoidosis, etc.
  • Occupational and environmental lung diseases: silicosis, pneumonia, etc.
  • Pulmonary vessel diseases: pulmonary embolism, pulmonary hypertension, etc.
  • Pleural effusion: Pleuritis, mesothelioma, tuberculosis pleuritis, etc.
  • Sleep Apnea

What is Asthma?

Asthma is a clinical chronic/ long-term syndrome that affects the airways, which are the tubes through which air flows to the lungs. However, It causes inflammation and narrowing of these air passages, which leads to restriction or blocking of airflow to the lungs. Therefore, asthma patients are exposed to various triggers such as inhaling substances that provoke allergic reactions and irritate the respiratory system, this will lead to airway hyper-reactivity, which causes narrowing the airways and swelling of the bronchi. As a result, the mucous glands of the bronchi are usually inflamed inner parts of the airways are filled with mucus. This makes breathing very difficult and leads to asthma symptoms such as phlegm, coughing, or an asthma attack.

What are the symptoms of Asthma?

Not everyone can experience the same sign and symptoms, Asthma can cause different symptoms for each person. The most common symptoms are:

  • Coughing: usually occurs at night or early in the morning, also it can occur at any time of the day. Coughing is the most common symptom of asthma, especially in children. Sometimes a frequent cough is accompanied by sneezing and a runny nose
  • Wheezing and difficulty breathing.
  • Shortness of breath.
  • There may be a disturbance in eating, sleeping, or even speaking due to shortness of breath.
  • A feeling of heaviness or pressure in the chest.
  • Increased production of the respiratory mucosa.

What are the factors that cause or trigger an Asthma Attack?

  • Inflammation (Allergies) can cause bronchitis or tightening of the bronchial muscles
  • House dust
  • Animal fur or bird feathers
  • Pollen grains
  • Respiratory viral infection
  • Allergens such as dust mites

There are some triggers that do not cause sensitivity or swelling, yet they can affect a bronchial twitching, especially if it is inflamed, and these triggers include:

  • Smoking
  • Exercise
  • Cold weather
  • Other strong-odor substances such as chemical fumes and fragrances
  • Emotion: laughing, crying, and shouting may trigger an asthma attack

What are the Protection and Management methods of Asthma?

Although there is challenging to know how to prevent the inflammatory condition, yet you can take few steps every day to help reduce your risk for asthma attack incidence and as well as make yourself healthier. These include:

  • Follow your own asthma control program
  • Taking influenza and pneumonia vaccines to reduce the severity of influenza
  • Regularly follow-up appointments, adhering to the guidelines and instructions to all basic examination
  • Detect and treat seizures early.
  • Take your medication as prescribed on a daily basis.
  • Minimize the use of bronchodilators as much as possible.

Avoid asthma triggers to prevent the incidence of attacks, such as:

Avoid pets: Furry pets are a common trigger for an asthma attack. If you have a pet like cats, birds, or others, it is preferable to stay away from them as much as possible, as feathers and fur are among the triggers that cause sensitivity and irritation in the airways, which leads to an asthma attack. As a result, if the pet should be kept outside, vacuum your living space often and clean the floor weekly with a mop.

Dust or Mold: Inhaling mold can trigger an asthma attack. The amount of moisture in the air can cause mold to grow in your home. Moreover, an air conditioner or dehumidifier will help keep the humidity level down. Therefore, you can get a small tool called a hygrometer to check humidity levels and keep it as low as possible, no higher than 50%.

Protection from cockroaches: Cockroaches can trigger an asthma attack. Cockroaches are often found in places that contain leftovers. However, sweep or mop areas that may attract cockroaches at least every two to three days a week. Use insect traps or gels to reduce the number of roaches in your home

Protection from exposure to allergens: Pollen is a very common cause of asthma symptoms. The airborne pollen produced by trees, meadows, and weeds can be inhaled, especially in spring weather. However, use an air cleaner with a filter (HEPA), and if you are outside on a day with a high pollen count, shower and change your clothes.

Air pollution protection: Pollution from industrial emissions and automobile exhausts can trigger an asthma attack. In addition, pay attention to the weather and air forecasts on radio, television, and the Internet, and if air pollution causes asthma, plan your activities for times when air pollution levels are low.

How is Asthma Diagnosed?

There is no single test or examination that will define whether you or your child has asthma. Instead, a doctor will use a variety of criteria to determine whether the symptoms you have are due to asthma. The following can help diagnose Asthma:

  • The Health and Medical History of the patient, as the risk is greater if a family member suffers from a respiratory or breathing disorder.
  • Physical examination.
  • Doing a blood or skin allergy test to look for signs of an allergy, such as if it is due to pollen, dust, or eczema that increases the risk of developing asthma
  • Respiratory function tests: These include Pulmonary Function tests and breathing tests. measuring airflow into and out of your lung with
  • Spirometry, the most common test that measures how much air you exhale, how much you inhale, and how quickly you exhale inside your lung.

Asthma Treatments

Asthma treatment aims to:

  • Control symptoms appropriately
  • Reduce the risk of future complications,
  • Maintain normal lung and respiratory functions
  • Maintain normal levels of respiratory organs activity
  • Take as few medications as possible to reduce side effects.
  • Inhaled corticosteroids are the most effective anti-inflammatory against chronic diseases like asthma and are the first-line treatment for most asthma problems. Moreover, it helps to reduce mucus production and swelling in the airways, making breathing easier.
  • Short-acting beta-agonists have a long-term effect. In addition, improving asthma control within minutes by reducing mucus and opening your airways.
  • Quick-reliefs inhalers such as (fluticasone oral inhalation) provide muscle relaxation by tightening muscle around the airways. As a result, it helps open them up so the breathing can be performed easier and prevent tightness and difficulty breathing


Pneumonia is an infection that attacks the air sacks (alveoli) in the lungs due to a virus, bacterium, or fungus get into one of the lungs. In conclusion, it causes these tiny sacs inside the lungs to get inflamed and fill with pus or fluid, causing symptoms such as cough with phlegm, fever, and difficulty breathing

What are the symptoms of Pneumonia?

Symptoms of pneumonia vary from mild to severe. How the body responds to pneumonia depends on the type of microbe causing the infection, the age, and the person’s health. Signs and symptoms of pneumonia include:

  • A cough with phlegm or producing sputum
  • Fever, sweating, shivering, and chills
  • Shortness of breath or difficulty breathing
  • Rapid breathing
  • Sharp pain or tingling in the chest that worsens when breathing deeply or when coughing
  • Lack of appetite
  • Low energy and fatigue
  • Nausea and vomiting, especially in young children, and confusion in the elderly

Is Pneumonia Contagious?

A variety of germs cause pneumonia including viruses, bacteria, and fungi. Besides, these germs which cause pneumonia are contagious which means they can spread from person to person. In other words, both bacterial and viral pneumonia are able to spread through inhaling airborne droplets from coughing or sneezing.

Also, it can be spread by coming into contact with objects or surfaces that are contaminated with bacterial and viral caused-pneumonia. However, fungal pneumonia can be transmitted from the environment, it does not spread from person to person.

What are the risk factors for developing Pneumonia?

  • Anyone can develop pneumonia, but certain groups are at a higher risk, these include the following:
  • Children under 2 years old
  • People who are age 65 or older
  • Those with the weakened immune system due to medication or disease, such as some cancer drugs or steroids
  • People suffering from some chronic medical conditions such as asthma, diabetes, cystic fibrosis, or heart failure
  • Who recently had a respiratory infection, such as cold or influenza
  • People who are recently or currently hospitalized, particularly those who were on ventilators
  • Those who have had a stroke, difficulty swallowing, or a condition that causes lethargy
  • Smoking, taking certain medications, or drinking large amounts of alcohol
  • Those who were exposed to lung irritants such as pollution, smoke, and some chemicals

How to Prevent Pneumonia?

The risk of developing pneumonia can be reduced by following a few simple steps. Among the ways to prevent pneumonia are:

  • Vaccination. Vaccines are used to prevent some types of infection with the microorganisms that cause pneumonia and influenza. Most importantly, your doctor determines the appropriate vaccine for your condition and vaccination guidelines for immunization and trying to prevent pneumonia and infection.
  • Good hygiene. Good habits help to protect you against respiratory infections that sometimes cause pneumonia. For example, keeping your face and hands clean with soap or hand sanitizer to kill the germs or any microbes that cause the disease.
  • Stop smoking. It is the most effective way to prevent infection, as smoking harms the natural protection of the lungs and makes it harder for the lungs to fight off germs, and able to leads to more health problems.
  • Maintaining a strong immune system. Getting enough sleep, exercise regularly, and eat a healthy diet help to keep your immune system strong.

Vaccines used to Prevent Pneumonia

Vaccination is the first line of defense which provides protection against pneumonia, such as the pneumococcal vaccine, which comes in two formulations: Prevnar 13 and Pneumovax 23

Prevnar 13: This type is effective and protects against 13 types of pneumococcal bacteria, as it provides protection against pneumonia, meningitis, and blood infections caused by pneumococcal bacteria. However, it is recommended for the following groups:

  • Children under 2 years old
  • People who are age 65 or older
  • people between ages 2 and 64 years with chronic health problems that increase their risk for pneumonia

Polysaccharide 23: is effective against 23 types of pneumococcal bacteria. They recommend it for the in the following groups:

  • Adults aged 65 and over
  • Smokers between the ages of 19 and 64 years
  • People between the ages of 2 to 64 who have chronic health problems that increase the risk of developing pneumonia

Pneumonia Treatment

The treatment depends on the severity and type of pneumonia, your overall health, and your age. Your doctor may prescribe medication to treat pneumonia. However, treatment options include the following Antibiotics: Antibiotics are effective against bacterial pneumonia infections. Antibiotic drugs are ineffective in treating the virus pneumonia. Certainly, your doctor may prescribe an antiviral. However, many cases of viral pneumonia clear up on their own with home care and home remedies. Antifungal medications are used to combat fungal pneumonia. You may need to use this medication for several weeks to clear up the infection.

Doctors of the Thoracic Department at Avicenna International Hospital

The specialist Dr. Nazmi Demirtaş was born in Sivas in 1966. He completed his primary and secondary education in Ankara, and entered the Medical College of Ataturk University in 1984., and graduated in 1990. Moreover, he completed his residency in 1990-1993. In 1993 he started his specialty in thoracic diseases and tuberculosis at the Medicine Faculty at the Republic University. In 1997, he worked as a Thoracic specialist in a private hospital in Istanbul. Moreover, he has been working as a Thoracic and tuberculosis specialist and a chief physician at Atasehir Avicenna Hospital since 1998.

Important note: Patients suffering from the above-mentioned problems and diseases should be evaluated and followed up by Thoracic disease specialists according to the age. If you are over 18 years old, you should be examined by thoracic disease specialists for Adults. Similarly, to the younger cases.

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