Emphysema gradually damages the air sacs (alveoli) in your lungs, making you progressively more short of breath. Emphysema is one of several diseases known collectively as chronic obstructive pulmonary disease (COPD).
Your lungs' alveoli are clustered like bunches of grapes. In emphysema, the inner walls of the air sacs weaken and eventually rupture — creating one larger air space instead of many small ones. This reduces the surface area of the lungs and, in turn, the amount of oxygen that reaches your bloodstream.
When you exhale, the damaged alveoli don't work properly and old air becomes trapped, leaving no room for fresh, oxygen-rich air to enter. Treatment may slow the progression of emphysema, but it can't reverse the damage.
SYMPTOMS
You can have emphysema for many years without noticing any signs or symptoms. The main symptom of emphysema is shortness of breath, which usually begins gradually. You may start avoiding activities that cause you to be short of breath, so the symptom doesn't become a problem until it starts interfering with daily tasks. Emphysema eventually causes shortness of breath even while you're at rest.
See your doctor if you've had unexplained shortness of breath for several months, especially if it's getting worse or it's interfering with your daily activities. Don't try to attribute it to your deconditioning or age or weight. Seek immediate medical attention if:
You're so short of breath, you can't climb stairsYour lips or fingernails turn blue or gray with exertionYou're not mentally alert
CAUSES
The main cause of emphysema is long-term exposure to airborne irritants, including:
Tobacco smokeMarijuana smokeAir pollutionManufacturing fumes
Rarely, emphysema is caused by an inherited deficiency of a protein that protects the elastic structures in the lungs. It's called alpha-1-antitrypsin deficiency emphysema.
COMPLICATIONS
People who have emphysema are also more likely to develop:
Collapsed lung (pneumothorax). A collapsed lung can be life-threatening in people who have severe emphysema, because the function of their lungs is already so compromised. This is uncommon but serious when it occurs.Heart problems. Emphysema can increase the pressure in the arteries that connect the heart and lungs. This can cause a condition called cor pulmonale, in which a section of the heart expands and weakens.Large holes in the lungs (giant bullae). Some people with emphysema develop empty spaces in the lungs called bullae. Giant bullae can be as large as half the lung. In addition to reducing the amount of space available for the lung to expand, giant bullae can increase your risk of pneumothorax.
DIAGNOSIS
To determine if you have emphysema, your doctor may recommend a variety of tests.
Imaging tests
A chest X-ray can help support a diagnosis of advanced emphysema and rule out other causes of shortness of breath. But the chest X-ray can also show normal findings if you have emphysema. Computerized tomography (CT) scans combine X-ray images taken from many different directions to create cross-sectional views of internal organs. Your doctor may want you to have a CT scan if you're considering lung surgery.
Lab tests
Blood taken from an artery in your wrist can be tested to determine how well your lungs transfer oxygen into, and remove carbon dioxide from, your bloodstream.
Lung function tests
These noninvasive tests measure how much air your lungs can hold and how well the air flows in and out of your lungs. They can also measure how well your lungs deliver oxygen to your bloodstream. One of the most common tests uses a simple instrument called a spirometer, which you blow into.
TREATMENT
Emphysema can't be cured, but treatments can help relieve symptoms and slow the progression of the disease.
Medications
Depending upon the severity of your symptoms, your doctor might suggest:
Bronchodilators. These drugs can help relieve coughing, shortness of breath and breathing problems by relaxing constricted airways, but they're not as effective in treating emphysema as they are in treating asthma or chronic bronchitis.Inhaled steroids. Corticosteroid drugs inhaled as aerosol sprays may help relieve shortness of breath. Prolonged use may weaken your bones and increase your risk of high blood pressure, cataracts and diabetes.Antibiotics. If you develop a bacterial infection, like acute bronchitis or pneumonia, antibiotics are appropriate.
Therapy
Pulmonary rehabilitation. A pulmonary rehabilitation program can teach you breathing exercises and techniques that may help reduce your breathlessness and improve your ability to exercise. Nutrition therapy. You'll also receive advice about proper nutrition. In the early stages of emphysema, many people need to lose weight, while people with late-stage emphysema often need to gain weight. Supplemental oxygen. If you have severe emphysema with low blood oxygen levels, using oxygen regularly at home and when you exercise may provide some relief. Many people use oxygen 24 hours a day. It's usually administered via narrow tubing that fits into your nostrils.
Surgery
Depending on the severity of your emphysema, your doctor may suggest one or more different types of surgery, including:
Lung volume reduction surgery. In this procedure, surgeons remove small wedges of damaged lung tissue. Removing the diseased tissue helps the remaining lung tissue expand and work more efficiently and helps improve breathing.Lung transplant. Lung transplantation is an option if you have severe emphysema and other options have failed.
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| Emphysema |
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| Damaged alveoli |
SYMPTOMS
You can have emphysema for many years without noticing any signs or symptoms. The main symptom of emphysema is shortness of breath, which usually begins gradually. You may start avoiding activities that cause you to be short of breath, so the symptom doesn't become a problem until it starts interfering with daily tasks. Emphysema eventually causes shortness of breath even while you're at rest.
See your doctor if you've had unexplained shortness of breath for several months, especially if it's getting worse or it's interfering with your daily activities. Don't try to attribute it to your deconditioning or age or weight. Seek immediate medical attention if:
You're so short of breath, you can't climb stairsYour lips or fingernails turn blue or gray with exertionYou're not mentally alert
CAUSES
The main cause of emphysema is long-term exposure to airborne irritants, including:
Tobacco smokeMarijuana smokeAir pollutionManufacturing fumes
Rarely, emphysema is caused by an inherited deficiency of a protein that protects the elastic structures in the lungs. It's called alpha-1-antitrypsin deficiency emphysema.
COMPLICATIONS
People who have emphysema are also more likely to develop:
Collapsed lung (pneumothorax). A collapsed lung can be life-threatening in people who have severe emphysema, because the function of their lungs is already so compromised. This is uncommon but serious when it occurs.Heart problems. Emphysema can increase the pressure in the arteries that connect the heart and lungs. This can cause a condition called cor pulmonale, in which a section of the heart expands and weakens.Large holes in the lungs (giant bullae). Some people with emphysema develop empty spaces in the lungs called bullae. Giant bullae can be as large as half the lung. In addition to reducing the amount of space available for the lung to expand, giant bullae can increase your risk of pneumothorax.
DIAGNOSIS
To determine if you have emphysema, your doctor may recommend a variety of tests.
Imaging tests
A chest X-ray can help support a diagnosis of advanced emphysema and rule out other causes of shortness of breath. But the chest X-ray can also show normal findings if you have emphysema. Computerized tomography (CT) scans combine X-ray images taken from many different directions to create cross-sectional views of internal organs. Your doctor may want you to have a CT scan if you're considering lung surgery.
Lab tests
Blood taken from an artery in your wrist can be tested to determine how well your lungs transfer oxygen into, and remove carbon dioxide from, your bloodstream.
Lung function tests
These noninvasive tests measure how much air your lungs can hold and how well the air flows in and out of your lungs. They can also measure how well your lungs deliver oxygen to your bloodstream. One of the most common tests uses a simple instrument called a spirometer, which you blow into.
TREATMENT
Emphysema can't be cured, but treatments can help relieve symptoms and slow the progression of the disease.
Medications
Depending upon the severity of your symptoms, your doctor might suggest:
Bronchodilators. These drugs can help relieve coughing, shortness of breath and breathing problems by relaxing constricted airways, but they're not as effective in treating emphysema as they are in treating asthma or chronic bronchitis.Inhaled steroids. Corticosteroid drugs inhaled as aerosol sprays may help relieve shortness of breath. Prolonged use may weaken your bones and increase your risk of high blood pressure, cataracts and diabetes.Antibiotics. If you develop a bacterial infection, like acute bronchitis or pneumonia, antibiotics are appropriate.
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| Inhaler |
Pulmonary rehabilitation. A pulmonary rehabilitation program can teach you breathing exercises and techniques that may help reduce your breathlessness and improve your ability to exercise. Nutrition therapy. You'll also receive advice about proper nutrition. In the early stages of emphysema, many people need to lose weight, while people with late-stage emphysema often need to gain weight. Supplemental oxygen. If you have severe emphysema with low blood oxygen levels, using oxygen regularly at home and when you exercise may provide some relief. Many people use oxygen 24 hours a day. It's usually administered via narrow tubing that fits into your nostrils.
Surgery
Depending on the severity of your emphysema, your doctor may suggest one or more different types of surgery, including:
Lung volume reduction surgery. In this procedure, surgeons remove small wedges of damaged lung tissue. Removing the diseased tissue helps the remaining lung tissue expand and work more efficiently and helps improve breathing.Lung transplant. Lung transplantation is an option if you have severe emphysema and other options have failed.
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