Emphysema is one of the conditions that makes up chronic obstructive pulmonary disease (COPD). Smoking and exposure to secondhand smoke and air pollution contribute to both emphysema and bronchitis.
Over time, people with emphysema may develop shortness of breath even when at rest. This happens because the walls of their air sacs have weakened and ruptured.
1. Breathing Problems
The damaged lung tissue in emphysema can cause shortness of breath. People with early-stage emphysema may notice that they get short of breath when they exercise or when they go up stairs. As the disease progresses, they will experience shortness of breath more frequently. Eventually, they will experience shortness of breath all the time. This is referred to as air hunger and can interfere with daily activities.
To diagnose emphysema, your healthcare provider will perform a physical exam and ask about your past health history. They will use a stethoscope to tap on your chest and listen for a hollow sound when you breathe. This is a sign that your lungs are collapsing and trapping air, which is a characteristic of emphysema. They will order a variety of tests to confirm the diagnosis, including X-rays and computerized tomography (CT) scans of your chest. A CT scan creates cross-sectional images of your lungs and is more helpful in diagnosing emphysema than an X-ray. They may also order a blood test to measure the levels of oxygen and carbon dioxide in your blood.
Medications used to treat emphysema include corticosteroid drugs that reduce inflammation and help you breathe easier. You may also be prescribed mucolytics, medications that thin the thickened mucus in your lungs and make it easier to cough up. People with a genetic disorder called alpha-1 antitrypsin deficiency may benefit from intravenous augmentation therapy, which involves infusion of the purified Alpha-1 antitrypsin protein to increase oxygen levels in the blood.
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If you are a smoker, quitting smoking is the best way to slow the progression of emphysema. Avoiding other irritants, such as secondhand smoke, chemical fumes, air pollution and dust from some kinds of manufacturing, can also help.
2. Coughing
A cough may be one of the first symptoms of emphysema. This chronic cough typically produces a lot of phlegm and may have a wheezing or crackling sound. It is usually triggered by exercise or physical exertion and gets worse over time. Eventually, it can affect daily activities and lead to shortness of breath even while at rest. This can cause anxiety and lead to heart problems, if it becomes severe.
People with emphysema often develop other lung conditions, such as chronic bronchitis and pneumonia. These conditions can make a person more sensitive to the irritation and swelling of airways, which triggers phlegm production and causes coughing. Coughing may also occur more frequently during a COPD exacerbation (sudden worsening of symptoms).
Emphysema is caused by damage to the walls of the alveoli in the lungs, where oxygen and carbon dioxide are exchanged. This can be a result of cigarette smoking or exposure to dust and air pollutants. In some cases, it is due to a genetic condition called alpha-1-antitrypsin deficiency.
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The lungs are sponge-like organs that lie within the chest, protected by the ribcage. They are made up of progressively branching air passages, including the windpipe, trachea and bronchi, which then divide into smaller bronchioles. Emphysema damages these air sacs, which can make them appear larger than normal and give a person a barrel-chested appearance. It also reduces the number of capillaries in the lungs, so less oxygen moves into the bloodstream. This can put extra strain on the heart and result in a blueish-gray color to the lips and fingernails from lack of oxygen. This can be dangerous and requires immediate medical attention.
3. Shortness of Breath
When you breathe in, air travels through your lungs and into bronchial tubes (the main lung airways). The bronchial tubes then divide into smaller tubes called bronchioles that end in clusters of tiny air sacs called alveoli. These air sacs are surrounded by blood vessels that absorb oxygen and release carbon dioxide when you exhale. Emphysema destroys the walls of these air sacs and prevents them from expanding as they should. This reduces the amount of oxygen in your blood and makes breathing difficult.
As the disease progresses, you may feel short of breath even at rest or when doing simple activities. The problem gets worse over time, especially if you continue to smoke or be exposed to secondhand smoke.
Your doctor can diagnose emphysema by listening to your breathing and doing an examination. You may also have a chest X-ray and lung-function tests to see how well your lungs are working.
Pulmonary function tests measure how much air your lungs can hold and help determine the stage of emphysema you have. These tests include spirometry, in which you blow forcefully into a tube connected to a machine that measures your lung capacity. Your doctor may also order a CT scan of your chest to look for damaged lungs.
Some treatments for emphysema focus on lifestyle changes, such as stopping smoking and avoiding secondhand smoke. Your doctor may prescribe medications, such as bronchodilators that open your airways to make breathing easier, and phosphodiesterase inhibitors that reduce inflammation. Other treatments include pulmonary rehabilitation, exercise to strengthen breathing muscles, and oxygen therapy.
4. Chest Pain
Chest pain is a common symptom of emphysema. This pain often occurs when people are active or when they inhale or exhale. Chest pain associated with emphysema can be confused with symptoms of heart disease, such as a heart attack. That’s why it’s important for people to report any chest pain and discuss it with their doctors.
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Emphysema results from damage to the walls of the air sacs in your lungs, called alveoli. The damaged walls can no longer expand or contract to move oxygen into and out of the lungs. This leads to large spaces in the lungs, making your chest appear fuller and giving you a barrel-chested appearance. It also reduces the surface area of the lungs, which makes it hard for fresh, oxygen-rich air to enter the lungs and help you breathe.
X-rays and CT scans can show changes in your lungs related to emphysema. These tests can also help rule out other conditions that may cause shortness of breath, such as chronic bronchitis or pneumonia. A stethoscope can be used to listen to your lungs. When you inhale, your doctor will hear a hollow sound that is typical of a person who has emphysema. The doctor may also order other tests to confirm the diagnosis, such as a blood test to measure your red and white blood cells. This can help determine whether you have a condition that affects how well your lungs work, such as alpha one antitrypsin deficiency (AATD).
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To treat emphysema, people should stop smoking and avoid other lung-irritants like fumes and chemicals. They should get regular medical care, including vaccinations for pneumonia and influenza. They should also exercise regularly and eat a healthy diet. For severe emphysema, oxygen therapy can help make breathing easier. Some people use a portable oxygen tank to provide oxygen at home, while others require continuous use of an oxygen machine.
