Symptoms Of Emphysema
Two of the key symptoms of emphysema are shortness of breath and a chronic cough appears in the early stages. A person with shortness of breath, or dyspnea, feels being unable to catch a breath may start only during physical exertion, but as the disease progresses, it can start to happen during rest, too. Emphysema and COPD develop over a number of years.
In the later stages, the person may have:
- Frequent lung infections,
- Excess production of mucus,
- Reduced appetite and weight loss,
- Blue-tinged lips or fingernail beds, or cyanosis, due to a lack of oxygen,
- Anxiety and depression,
- Sleep problems,
- Morning headaches due to a lack of oxygen, when breathing at night is difficult.
Complications In Emphysema
People who have emphysema are also more likely to develop:
- Collapsed lung (pneumothorax): A collapsed lung can be life-threatening
in people who have severe emphysema, because the function of their lungs is already so compromised. This is uncommon but serious when it occurs.
- Heart problems: Emphysema can increase the pressure in the arteries that connect the heart and lungs. This can cause a condition called corpulmonale, in which a section of the heart expands and weakens.
- Large holes in the lungs: Some people with emphysema develop empty spaces in the lungs called bullae. They can be as large as half the lung. In addition to reducing the amount of space available for the lung to expand, giant bullae can increase your risk of pneumothorax.
Tests and Diagnosis For Emphysema
Diagnosis will carry out a physical examination and ask the patient about their symptoms and medical history. Some diagnostic tests may also be used, to confirm that the patient has emphysema rather than asthma and heart failure. If the patient has never smoked; a test may be carried out to see if the person has an α1- antitrypsin deficiency.
- A chest X-ray helps to identify changes in lung that may indicate emphysema. The X-ray also may show the presence of an infection or a mass in the lung (such as a tumor) that could explain symptoms. Shortness of breath has many causes. The chest X-ray is
considered to be the quickest and easiest test to begin to separate the different possible causes and formulate a diagnosis.
- Lung function tests can give the specific information about how the lungs work mechanically. In these tests, the patient have to breathe into a tube that is connected to a computer or some other monitoring device, which can record the necessary information. The tests measure how much air in lungs can hold, how quickly lungs can expel air during expiration, and how much reserve capacity of lungs have for
increased demand, such as during exercise.
- Blood test is used to detect family history of α1-antitrypsin deficiency to
evaluate genetic disease.
- Blood tests may also be used to check white blood cell count, which can
sometimes indicate an acute infection. This information can be used with the chest X-ray to evaluate for pneumonia, bronchitis, or other respiratory infections that can make emphysema worse.
- Another blood test that may be helpful, especially in the hospital setting, is called the arterial blood gas. This test helps determine how much oxygen and carbon dioxide are in blood.
Treatment For Emphysema
Treatment for emphysema can take many forms in a step-wise approach, depending on the severity of condition. Medications used for treatment of emphysema are:
Bronchodilator: Salmeterol, Albuterol, Metaproterenol, and Formoterol Anticholinergic: Ipratropium bromide and Tiotropium
Steroids: Prednisone, Dexamethasone PDE4 inhibitors: Roflumilast
Stop smoking: This recommendation for people with emphysema, quitting smoking may halt the progression of the disease and improve the function of the lungs to some extent. Lung function deteriorates with age. In those susceptible to developing COPD, smoking can result in a five-fold deterioration of lung function. Smoking cessation may return lung function from this rapid deterioration to its normal rate after smoking is stopped.
Antibiotics: These medications are often prescribed for people with emphysema who have increased shortness of breath. Even when the chest X-ray does not show pneumonia or evidence of infection, people treated with antibiotics tend to have shorter episodes of shortness of breath. It is suspected that infection may play a role in an acute bout of emphysema, even before the infection worsens into a pneumonia or acute bronchitis.
Oxygen Therapy: As a patients’ disease progresses, they may find it increasingly difficult to breathe on their own and may require supplemental oxygen.
Surgery: People with severe emphysema sometimes undergo surgery to reduce lung volume or carry out lung transplantation. Lung volume reduction surgery removes small wedges of the damaged, emphysematous, lung tissue. This is thought to enhance lung recoil and to improve the function of the diaphragm. In severe cases, this can improve lung function, exercise tolerance and quality of life. Lung transplantation improves quality of life, but not life-expectancy, for people with severe emphysema. Lifelong drug therapy is necessary to prevent the immune system from rejecting the new tissue. One or both lungs may be transplanted.
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