Lung Emphysema

Lung emphysema is a chronic lung disease which leads to disruption of pulmonary functions. It may significantly reduce the patient's quality of life and some of its advanced forms may be directly life-threatening. The patophysiological mechanism of the disease is destruction of the septa between the alveoli. This decreases the functional alveolar lung surface, where the exchange of breathing gases takes place.


The emphysema may occur due to a genetically determined disorder such in case of alpha-1-antitrypsin deficiency. Very important causative factors are also inhaled pollutants such as the cigarette smoke. In addition, some degree of natural degeneration of the alveoli occurs in the process of aging.


The main symptoms are gradually progressing shortness of breath, fatigue and inefficiency. In addition, there may be symptoms of chronic bronchitis (cough, mucus expectoration), which frequently accompanies the emphysema. The emphysema can be evaluated as a certain subtype of disease known as COPD. Some forms of emphysema increase the risk of spontaneous pneumothorax due to rupture of the affected lung.


It is important to determine the nature of the patient's problems. It is important to know, if he is a smoker (and how many cigarettes a day he smokes), or if he comes to regular contact with other pollutants. When listening an emphysematic patient with a stethoscope, the breathing sounds are much weakened. The chest X-ray usually does not show clear pathology, but at least it rules out many other lung diseases. The patient should have examine his lung functions including the spirometry to asses the presence and severity of the lung disorder. Further approach depends on the result of the previously-mentioned methods.


Once developed emphysema can not be treated, but it is necessary to prevent further deterioration. Absolute ban of smoking is advisable. Oxygen is the medication of first choice; advanced stages of emphysema may even need the home oxygen therapy. In exceptional cases, local surgery may be used to remove the lung parts affected by emphysema. The ultimate solution may be a lung transplant, but only a minimal percentage of patients are capable of withstanding this procedure.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources