Emphysema is a type of chronic obstructive pulmonary disease (COPD) involving damage to the air sacs (alveoli) in the lungs. In people with emphysema, the lung tissues necessary to support the physical shape and function of the lung are destroyed. As a result, your body does not get the oxygen it needs. Emphysema is called an obstructive lung disease because the destruction of lung tissue around smaller airways, called bronchioles, makes these airways unable to hold their shape properly when you exhale.
The most common cause is cigarette smoking. If you smoke, quitting can help prevent you from getting the disease. Cigarettes contain many hazardous substances that damage the lung when inhaled, including tar nicotine, carbon monoxide, and cyanide. If you already have emphysema, not smoking might keep it from getting worse. Long-term exposure to secondhand tobacco smoke and/or repeated respiratory infections also can increase a person's risk for COPD. Other risk factors include a deficiency of an enzyme called alpha-1-antitrypsin, air pollution, airway reactivity, heredity, male sex, and age. Lung function normally declines with age. Therefore, it stands to reason that the older the person, the more likely they will have enough lung tissue destruction to produce emphysema.
Shortness of breath is the most common symptom of emphysema. Cough, sometimes caused by the production of mucus, and wheezing may also be symptoms of emphysema. You may notice that your tolerance for exercise decreases over time. Emphysema usually develops slowly. You may not have any acute episodes of shortness of breath. Slow deterioration is the typical, and it may go unnoticed. This is especially the case if you are a smoker or have other medical problems.
People with emphysema may develop a "barrel chest," where the distance from the chest to the back, which is normally less than the distance side to side, becomes more pronounced. This is a direct result of air becoming trapped behind obstructed airways.
When to Seek Medical Care
If you have new or worsening shortness of breath, seek medical attention by making an appointment with Dr. Tapp. Shortness of breath can occur with other diseases, particularly heart disease and other lung diseases, so it is important not to overlook or minimize this symptom. A gradual decrease in the ability to exercise or perform daily activities, a persistent cough, and wheezing also suggest a visit to Dr. Tapp.
If you have been diagnosed with emphysema, go to the hospital’s emergency patient admission if any new, severe, or worsening shortness of breath occur. Any hint of the lips, tongue, fingernails, or skin turning a shade of blue should prompt a visit to the hospital’s emergency unit. This symptom, called cyanosis, can indicate worsening of your lung condition. The inability to speak in full sentences may be a sign of shortness of breath.
Treatment is based on whether your symptoms are mild, moderate or severe.
- Bronchodilators. These drugs can help relieve coughing, shortness of breath and trouble breathing by opening constricted airways, but they're not as effective in treating emphysema as they are in treating asthma.
- Inhaled steroids. Corticosteroid drugs inhaled as aerosol sprays may relieve symptoms of emphysema associated with asthma and bronchitis.
- Supplemental oxygen. If you have severe emphysema with low blood oxygen levels, using oxygen at home may provide some relief. Various forms of oxygen are available as well as different devices to deliver them to your lungs.
- Protein therapy. Infusions of AAt may help slow lung damage in people with an inherited deficiency of the protein.
- Antibiotics. Respiratory infections such as acute bronchitis, pneumonia and influenza are a leading complication of emphysema. Broad-spectrum antibiotics may help relieve these symptoms.
- Inoculations against influenza and pneumonia. If you have emphysema or other forms of COPD, experts recommend an influenza (flu) shot annually and a pneumonia shot every five years after age 65.
- Surgery. In a procedure called lung volume reduction surgery (LVRS), surgeons remove small wedges of damaged lung tissue. Although it seems counterintuitive to treat diminished lung capacity by further reducing the size of the lungs which helps the remaining lung tissue and diaphragm work more efficiently.
- Transplant. Lung transplantation is an option if you have severe emphysema and other options have failed.
- Pulmonary rehabilitation program. A key part of treatment involves a pulmonary rehabilitation program, which combines education, exercise training and behavioral intervention to help restore you to the highest possible level of independent living.
If you have emphysema, follow-up care is crucial to managing this disease. You need to become a partner with Dr. Tapp in the management of your health. Emphysema is the fourth leading cause of death in the United States. It is a chronic, progressive disease that affects the quality of life at least as much as the length of life. Similar to many chronic diseases, the prognosis is affected by too many variables to be discussed here. Regular visits to Dr. Tapp's office and taking medications as prescribed are very important.
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