Emphysema, pulmonary:

Emphysema, pulmonary: 

Emphysema is a chronic lung condition in which the air sacs (alveoli) may be:

• Collapsed
• Destroyed
• Narrowed
• Overinflated
• Stretched

Overinflation of the air sacs is a result of a breakdown of the alveoli walls. It causes a decrease in respiratory function and breathlessness. Damage to the air sacs can't be fixed. It causes permanent breakdown in the lower lung tissue.

Pulmonary emphysema is part of a group of lung diseases called COPD (chronic obstructive pulmonary disease). COPD causes airflow blockage and breathing problems. The 2 most common conditions of COPD are chronic bronchitis and emphysema.

Causes

Pulmonary emphysema can be caused by several factors, with smoking being the main risk factor. The different causes lead to different parts of the lungs being affected.

Centrilobular pulmonary emphysema affects the upper part of the lung. It is believed that pollutants, such as cigarette smoke or other chemical substances, initially reach and damage the upper tissues of the lungs.

If the lower lung sections are affected in particular, this indicates a congenital defect of certain enzymes, leading to panlobular pulmonary emphysema. After lung surgery, during which parts of the lungs are removed, the residual lung may expand excessively. This leads to distension emphysema.

Symptoms 

Symptoms may be slightly different for each person. These are the most common:

• Cough
• Rapid breathing
• Shortness of breath, which gets worse with activity
• Sputum production
• Wheezing
• Other symptoms may include:
• Anxiety
• Depression
• Extreme tiredness (fatigue)
• Heart problems
• Overinflation of the lungs
• Sleep problems
• Weight loss

Diagnosis 

Along with a complete health history and physical exam, your healthcare provider may do pulmonary function tests. These tests help measure the lungs’ ability to exchange oxygen and carbon dioxide. The tests are often done with special machines into which you breathe. They may include:

Spirometry

A spirometer is a device used to check lung function. Spirometry is one of the simplest, most common tests. It may be used to:

• Determine the severity of a lung disease
• Find out if the lung disease is restrictive (decreased airflow) or obstructive (disruption of airflow)
• Look for lung disease
• See how well treatment is working
• Peak flow monitoring

This device measures how fast you can blow air out of your lungs. Cough, inflammation, and mucus buildup can cause the large airways in the lungs to slowly narrow. This slows the speed of air leaving the lungs. This measurement is very important in seeing how well or how poorly the disease is being controlled.

Blood tests

These are done to check the amount of carbon dioxide and oxygen in the blood. A blood test may be done to check eosinophil counts and vitamin D levels, and to monitor your hematocrit and hemoglobin levels for anemia.

Chest X-ray

This test takes pictures of internal tissues, bones, and organs. A chest X-ray is not recommended to diagnose COPD, but it can help identify other conditions.

CT scan

This test uses a combination of X-rays and computer technology to make images of the body. A CT scan can show details such as the width of airways in the lungs and the thickness of airway walls.

Sputum culture

This test is done on the material that is coughed up from the lungs and into the mouth. A sputum culture is often used to see if an infection is present. It may also be done to check eosinophil levels. It generally takes 2 days to get the results.

Electrocardiogram (ECG)

This is a test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias), and can help find heart muscle damage.