Definition
Emphysema is a lung disease that involves damage
to the air sacs (alveoli). The air sacs are
unable to completely deflate (hyperinflation)
and are therefore unable to fill with fresh air
to ensure adequate oxygen supply to the body.
Overview,
Causes, & Risk Factors
Cigarette smoking is the most common cause of
emphysema. Tobacco smoke and other pollutants
are thought to cause the release of chemicals
from within the lungs that damage the walls of
the air sacs. This damage becomes worse over
time, affecting the exchange of oxygen and
carbon dioxide in the lungs.
A naturally occurring substance in the lungs
called alpha-1 antitrypsin may protect against
this damage. People with alpha-1 antitrypsin
deficiency are at an increased risk for this
disease.
Emphysema
Symptoms & Signs
- Shortness of breath
- Chronic cough with or without sputum
production
- Wheezing
Additional symptoms that may be associated
with this disease include the following:
- Anxiety
- Unintentional weight loss
- Ankle, feet, and leg swelling
- Fatigue
Emphysema Diagnosis &
Tests
A physical examination may show decreased breath
sounds, wheezing, and/or prolonged exhalation
(exhalation takes more than twice as long as
inspiration). There may be an increased
front-to-back diameter of the chest, resemmbling
a barrel shape. There may be signs of
chronically insufficient oxygen levels in the
blood.
These tests help confirm the diagnosis:
- Pulmonary function tests
- Chest X-ray
This disease may also alter the results of
the following tests:
- Arterial blood gases showing reduced
oxygen
- Pulmonary ventilation/perfusion scan
- Chest CT scan
Emphysema Treatment
Smoking cessation is the most important and
effective treatment. Only quitting smoking can
stop the progression of lung damage once it has
started. Medications used to improve breathing
include bronchodilators (hand-held inhaler or
nebulizer), diuretics, and corticosteroids.
Antibiotics may be prescribed when respiratory
infections occur. Influenza (flu) vaccines and
Pneumovax are recommended for people with
emphysema.
Low-flow oxygen can be used during exertion,
continuously, or at night. Pulmonary
rehabilitation can improve exercise tolerance
and quality of life in the short-term. Lung
transplantation is an option for patients with
severe disease.
EXPERIMENTAL THERAPY:
An experimental surgery, called lung
reduction, is currently being studied in
patients with severe emphysema. Lung reduction
surgery removes the damaged portions of the
lung, which allows the normal portions of the
lung to expand more fully and take advantage of
increased aeration. It is not yet known whether
this surgery is effective.
Emphysema
Complications
- Recurrent respiratory infections
- Pulmonary hypertension
- Cor pulmonale (enlargement and strain on
the right side of the heart)
- Erythrocytosis (increased blood count)
- Death
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