Emphysema Introduction Emphysema is a type of chronic obstructive pulmonary disease, or COPD. COPD affects millions of people worldwide. Emphysema involves damage to the air sacs in the lungs. This makes it hard to catch your breath. This reference summary will help you understand emphysema. It discusses lung anatomy, symptoms, causes, diagnosis and treatment. Lungs The lungs help us breathe in oxygen and breathe out carbon dioxide. Everyone is born with 2 lungs: a right lung and a left lung. Breathing in is also called inhaling. Breathing out is also called exhaling. When we breathe air in through the nose or mouth, air goes down the windpipe and into the bronchial tubes, or air passageways of the lungs. The bronchial tubes divide into smaller passageways called bronchioles. The bronchioles also divide into smaller sacs called alveoli. The alveoli are lined with very small blood vessels. In the alveoli, blood gets rid of carbon dioxide and picks up oxygen from the air we breathe in. This process is called gas Lungs exchange. Alveoli 1
The airways and air sacs are stretchy. When you breathe in, each air sac fills up with air like a small balloon. When you breathe out, the air sacs deflate and the air goes out. Symptoms Emphysema usually doesn t cause symptoms at first. You can have emphysema for years before you notice any symptoms. Also, the symptoms of emphysema usually appear slowly. Shortness of breath is the main symptom of emphysema. You may not notice it at first. Instead, you may start to avoid activities that make you feel short of breath. As emphysema progresses, it may start to affect your daily activities. You may find it hard to complete everyday tasks because you feel short of breath. Eventually, emphysema can make you feel short of breath even while you are sitting still or resting. You should talk to your healthcare provider if you have shortness of breath that continues for several months. Your healthcare provider can tell you if emphysema is causing your shortness of breath. You should seek medical attention right away if your shortness of breath is so bad that you can t talk. Also seek emergency medical attention if you have the following symptoms: Blue or gray lips or fingernails Fast heartbeat Not mentally alert A normal heart beat is about 60 to 100 beats per minute when at rest. This means that the average heart beats 60 to 100 times in one minute when no strenuous physical activity is taking place. 2
Causes Many diseases can affect the lungs and how they function. It is more difficult to inhale and exhale when the lungs are affected by diseases like emphysema. In emphysema, the walls between many of the air sacs are damaged. This causes them to lose their shape and become floppy. As the walls of the air sacs are destroyed, the symptoms of emphysema worsen. Emphysema leads to fewer and larger air sacs instead of many tiny ones. If this happens, the amount of gas exchange in the lungs is reduced. The most common cause of emphysema is cigarette smoke. If you smoke, quitting can help prevent you from getting the disease. If you don t smoke make sure you stay away from people who do because secondhand smoke can also cause emphysema. Secondhand smoke is the smoke given off by a burning tobacco product or the smoke exhaled by a smoker. This smoke is harmful to any person who comes into contact with it. Not smoking and staying away from people who smoke might also keep emphysema from getting worse if you already have the disease. Talk to your healthcare provider about options to help you quit smoking. Emphysema can also be caused by other irritants that you breathe in, such as air pollution. Certain fumes as well as coal and other types of dust can also cause emphysema. A rare cause of emphysema is an inherited genetic defect. This is known as AAT deficiency, or Alpha-1-antitrypsin deficiency. People with this type of emphysema don t have enough of a certain protein that protects the stretchy parts of the lungs, such as the alveoli. Risk Factors Risk factors are factors that can increase the chances of getting a certain disease. This section examines a few risk factors for emphysema. 3
Smoking is the main risk factor for emphysema. Smoking cigarettes increases the chances of developing emphysema the most. However, pipe and cigar smokers are also at an increased risk. Even if you don t smoke yourself, being around secondhand smoke can increase your risk for emphysema. Secondhand smoke is smoke that comes from the burning of a tobacco product. Smoke that is exhaled by smokers is also secondhand smoke. Age is another risk factor for emphysema. Most people begin to experience the symptoms of emphysema between 40 and 60 years of age. This is especially true for smokers. Another risk factor for emphysema is inhaling certain fumes or dust at work. Repeated exposure increases the chances of getting emphysema, especially if you also smoke. You can reduce your risk by wearing a mask. Exposure to pollution is also a risk factor for emphysema. Both indoor pollutants and outdoor pollutants increase your risk for emphysema. Diagnosis If you have symptoms of emphysema, your healthcare provider will try to find out if emphysema is the cause of your symptoms or if there is another cause. After examining you, your healthcare provider may order some imaging tests to find the cause of your symptoms. One imaging test that may be done is a chest x-ray. A chest x-ray can rule out other causes of your symptoms. A CT scan is another imaging test that may be done. A CT scan is an x-ray machine linked to a computer. It takes a series of detailed pictures of your organs. Lab tests can also help your healthcare provider find the cause of your symptoms. A blood sample can be tested to tell how well your lungs are exchanging oxygen and carbon dioxide. 4
Lung function tests measure how well the lungs work and can help diagnose emphysema. This includes how much air the lungs can hold and how quickly air is moved into and out of the lungs. It also measures the levels of oxygen and carbon dioxide. Treatment There is no cure for emphysema. However, there are treatments available that can ease the symptoms and slow the development of emphysema. Quitting smoking can help ease the symptoms of emphysema. Treatment for emphysema may work better if you begin the treatment by quitting smoking. Treatment for emphysema is based on whether your Lung Function Test symptoms are mild, moderate or severe. Treatments may include inhalers, medications, oxygen and sometimes surgery. Inhalers containing steroids may be a treatment option for some people. These inhalers can help ease the symptom of shortness of breath. However, if used for a long time, steroid inhalers can cause serious side effects. Another treatment option for emphysema is bronchodilators. Bronchodilators are inhaled drugs that cause small airways in the lungs to open up. However, they may not be as effective as other treatments. Antibiotics can help treat infections in the lungs. Lung infections are more common in people with emphysema. Oxygen is another treatment for people with emphysema. Some people may use oxygen just when they exercise. Others may need oxygen all the time. Oxygen helps keep blood oxygen levels where they should be. Treatment with Oxygen 5
Another treatment option for emphysema is pulmonary rehabilitation. Pulmonary rehabilitation may include breathing exercises, and education on nutrition, medication and ways to reduce stress. Surgery may also be done to treat emphysema. Lung volume reduction is a surgery that removes damaged lung tissue. This helps you breathe easier because the healthy tissue can work better. Another surgery that may be done is a lung transplant. A lung transplant is usually only done for severe emphysema when all other treatments have failed. Summary Emphysema is a disease that involves damage to the air sacs in the lungs. This makes it hard to catch your breath. Emphysema usually doesn t cause any symptoms at first. You can have emphysema for years before you have any symptoms. The most common cause of emphysema is cigarette smoking. Smoking is also the main risk factor for emphysema. Talk to your healthcare provider about options to help you quit smoking. If you have symptoms of emphysema, your healthcare provider will try to find out if emphysema is the cause of your symptoms or if there is another cause. Various tests may be done to help diagnose emphysema. There are treatments available that can ease symptoms and slow the development of emphysema. Talk to your healthcare provider to learn more about emphysema and how it can be treated. 6