Diseases & Conditions

Emphysema

Emphysema is a factor in the progression of chronic obstructive pulmonary disease (COPD), a condition that limits the flow of air when you breathe out. Emphysema occurs when the air sacs at the ends of your smallest air passages (bronchioles) are gradually destroyed. Smoking is the leading cause of emphysema.

As it worsens, emphysema turns the spherical air sacs — clustered like bunches of grapes — into large, irregular pockets with gaping holes in their inner walls. This reduces the number of air sacs and keeps some of the oxygen entering your lungs from reaching your bloodstream. In addition, the elastic fibers that hold open the small airways leading to the air sacs are slowly destroyed, so that they collapse when you breathe out, not letting the air in your lungs escape.

Airway obstruction, another feature of COPD, contributes to emphysema. The combination of emphysema and obstructed airways makes breathing increasingly difficult. Treatment often slows, but doesn't reverse, the process.

Emphysema symptoms are mild to begin with but steadily get worse as the disease progresses. The main emphysema symptoms are:

• Shortness of breath
• Wheezing
• Chest tightness
• Reduced capacity for physical activity
• Chronic coughing, which could also indicate chronic bronchitis
• Loss of appetite and weight
• Fatigue

When to see a doctor

• You tire quickly, or you can't easily do the things you used to do
• You can't breathe well enough to tolerate even moderate exercise
• Your breathing difficulty worsens when you have a cold
• Your lips or fingernails are blue or gray, indicating low oxygen in your blood
• You frequently cough up yellow or greenish sputum
• You note that bending over to tie your shoes makes you short of breath
• You are losing weight

These signs and symptoms don't necessarily mean you have emphysema, but they do indicate that your lungs aren't working properly and should be evaluated by your doctor as soon as possible.

Emphysema can increase the severity of other chronic conditions, such as diabetes and heart failure. If you have emphysema, air pollution or a respiratory infection can lead to an acute COPD exacerbation, with extreme shortness of breath and dangerously low oxygen levels. You may need admission to an intensive care unit and temporary support from an artificial breathing machine (ventilator) until the infection clears.