Taking the patient’s medical history in a detailed interview and performing a physical examination are the basis for any further diagnostics.

The lung function cabin (whole-body plethysmography) enables numerous respiratory and lung parameters to be recorded for further diagnostics. At the same time, the respiratory gases are measured in order to additionally derive the capacity of the pulmonary alveoli to exchange oxygen and carbon dioxide (DLCO).

This examination is usually supplemented by an analysis of the blood gases in the arterial or capillary blood. This also determines the balance of acids and bases in the blood, which is largely regulated by respiration.

Ultrasound can be used to visualize the chest wall, pleural cavity and pathological changes in the lungs.

In order to differentiate cardiac diseases, it is often necessary to examine the heart by means of echocardiography, ECG at rest as well as under stress (ergometry).

Radiological examinations are of great importance in diagnostics. Technical development allows for ever lower radiation exposure with the most modern equipment (e.g., with ultra-low-dose technology). We cooperate with several radiological practices to perform these examinations.

Depending on the duration of the cough, different causes can be found. The most important diseases are shown below:

• Acute cough (< 2 weeks):
  Cold infections, allergic diseases, pulmonary embolisms and heart disease.
• Subacute cough (2-8 weeks):
  Postinfectious cough with transient bronchial hypersensitivity, pneumonia and pleurisy, whooping cough, and infections with mycoplasma and adenovirus.
• Chronic cough (> 8 weeks):
  A variety of serious inflammatory or structural diseases of the lung come into question here. In addition, differentiation from diseases of other organs is necessary.

Infections caused by unusual pathogens, localization, course or severity of the disease as well as the accumulation of infections may be indications of an immunodeficiency. In addition, a congenital immunodeficiency should be considered in various diseases, such as granulomatous diseases, autoimmune diseases, chronic intestinal diseases, and recurrent fever and unusual skin diseases. Although these are congenital diseases, in the majority of cases the diagnosis is not made until adulthood.

By means of a stepwise laboratory diagnosis, the defect can be clarified and, if necessary, supplemented by molecular genetic diagnostic confirmation.

Asthma is an inflammatory disease of the airways with hypersensitivity of the bronchial mucosa and alternating increase in airway resistance. This leads to coughing, chest tightness, shortness of breath and audible breathing sounds, especially on exhalation. Allergens are often the triggers, so that an allergological clarification is always necessary (-> Allergology).

In most cases, long-term drug therapy is required. Various anti-inflammatory and bronchodilator sprays, leukotriene receptor antagonists and biologics (anti-IgE or anti-IL5) are used for this purpose. Long-term therapy with cortisone as tablets can thus almost always be avoided.

COPD (“chronic obstructive pulmonary disease”) is a disease with persistent, usually progressive narrowing of the airways. Smoking is often the cause and leads to inflammation of the small airways and destruction of the lung tissue (emphysema). Genetic factors (e.g., alpha-1 antitrypsin deficiency) may increase susceptibility. The incidence in the adult population is 5 to 10%.

Drug therapy is usually with bronchodilator and anti-inflammatory sprays. In severe courses, phosphodiesterase-4 inhibitors or cortisone are used. If there is extensive emphysema, endoscopic or surgical lung volume reduction may be useful.

In advanced lung diseases, oxygen uptake is often impaired. This severely impairs physical and mental performance and reduces life expectancy. A prerequisite for the prescription of oxygen therapy is the precise analysis of blood gases. In suitable cases, various systems (oxygen concentrator, liquid oxygen, oxygen pressure cylinders) can then be used at home and on the road.

Sarcoidosis is an inflammatory disease that primarily affects the lungs and lymph nodes. In addition, numerous other organs, such as the liver, skin, eyes, brain and heart can also be affected. After imaging studies such as X-ray, PET (positron emission tomography) and MRI have shown the extent of the disease, the diagnosis is confirmed by biopsy.

In the case of symptomatic organ involvement as well as involvement of the heart or brain, therapy with cortisone, immunosuppressants or biologics is required.

Lung cancer is the second most common malignant tumor in men and the third most common in women. Smoking is the most important risk factor. About 85% of lung cancer deaths are attributable to smoking.

At diagnosis, the disease is usually advanced. In addition to nicotine abstinence, early detection therefore plays an important role. Since therapy varies greatly depending on the extent and type of tumor, a complete diagnosis, including a biopsy of the tumor tissue, is first required. The therapy is then determined in an interdisciplinary conference, taking into account all individual factors. Surgery, chemotherapy and radiotherapy form the pillars of treatment. In addition to combating the tumor disease, medical support during therapy is particularly important for quality of life.

This is a chronically progressive scarring of the connective tissue of the lungs, which becomes apparent as coughing and breathing difficulties on exertion. After exclusion of treatable causes, the diagnosis is confirmed by computer tomography and biopsy. Medications directed against the progressive scarring can influence the course of the disease. In addition, long-term oxygen therapy can improve the quality of life.