Pulmonary Emphysema | Johns Hopkins Medicine

What is pulmonary emphysema?

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 holes in the lower lung tissue.

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

What causes pulmonary emphysema?

Pulmonary emphysema occurs very slowly over time. It’s caused by:

• Smoking (the main cause)
• Exposure to air pollution, such as chemical fumes, dust, and other substances
• Irritating fumes and dusts at work
• A rare, inherited form of the disease called alpha 1-antitrypsin (AAT) deficiency-related pulmonary emphysema or early onset pulmonary emphysema

What are the symptoms of pulmonary emphysema?

Symptoms may be slightly different for each person. The following are the most common symptoms for pulmonary emphysema.

Early symptoms of pulmonary emphysema may include:

• 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
• Over-inflation of the lungs
• Sleep problems
• Weight loss

The symptoms of pulmonary emphysema may look like other lung conditions or health problems. See a healthcare provider for a diagnosis.

How is pulmonary emphysema diagnosed?

Along with a complete health history and physical exam, your healthcare provider may
request 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.

Chest X-ray

This test takes pictures of internal tissues, bones, and organs.

CT scan

This test uses a combination of X-rays and computer technology to make images of
the body. CT 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.

ECG

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

How is pulmonary emphysema treated?

The goal of treatment for people with pulmonary emphysema is to live more comfortably with the disease, control symptoms, and prevent the disease from getting worse, with minimal side effects. There is no way to repair or regrow the damaged lung tissue.

Treatment may include:

• A
  pulmonary rehab program. This may include breathing exercises to strengthen the
  muscles you use for breathing, and exercises for the rest of your body.
• Antibiotics for bacterial infections
• Staying
  away from the smoke of others and removing other air pollutants from your home and
  workplace
• Medicines (bronchodilators) that widen the airways of the lungs, and can be either
  taken by mouth (oral) or inhaled
• Getting the flu and pneumococcal vaccines
• Lung transplant
• Nutritional support since you may develop malnutrition and lose weight
• Other
  types of oral and inhaled medicines that are used to treat symptoms such as coughing
  and wheezing
• Oxygen therapy from portable containers
• Quitting smoking
• Surgery to remove the damaged area of the lung

Key points about pulmonary emphysema

• Pulmonary emphysema is a chronic lung condition. It’s often part of COPD, a group of
  lung diseases that cause airflow blockage and breathing problems.
• It
  develops very slowly over time. It’s most often caused by smoking.
• It
  causes shortness of breath that often gets worse with activity and many other
  symptoms, such as wheezing, cough, anxiety, and heart problems.
• There is
  no way to repair or regrow the damaged lung tissue. The goal of treatment for people
  with pulmonary emphysema is to live more comfortably, control symptoms, and prevent
  the disease from getting worse.
• A key
  part of treatment is to quit smoking.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your healthcare provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your healthcare provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your healthcare provider if you have questions.

Emphysema | healthdirect

On this page

If you or someone else are having severe trouble breathing call triple zero (000) immediately or go to your nearest emergency department

What is emphysema?

Emphysema is a condition that causes shortness of breath and coughing. It is one of several conditions that grouped together are known as chronic obstructive pulmonary disease (COPD).

In people with emphysema, the air sacs, or alveoli, of the lungs are damaged. This causes the small airways to collapse when air is breathed out, which makes it hard for air to flow into the lungs and even harder for it to flow out. Over time, the lung tissue becomes stiff and cannot take oxygen into the body as effectively.

What are the symptoms of emphysema?

The symptoms of emphysema depend on how severe the underlying lung disease has become. People with emphysema are often short of breath. As the disease progresses, the periods of breathlessness become more frequent. It becomes harder to do everyday activities or to exercise. Eventually, people are continually short of breath, even when sitting or lying down.

People with emphysema also often have:

• a persistent cough
• phlegm
• wheezing
• weight loss
• swelling of the feet and legs, which can be a sign of heart problems

At times, the symptoms may get worse suddenly. This may mean you should see a doctor – for example, in case you need antibiotics for a chest infection.

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

What causes emphysema?

Most people with emphysema smoke or have smoked in the past. A very small proportion of people get emphysema because they inherited a faulty gene that normally helps to keep the air sacs of the lungs healthy.

Other causes of emphysema include:

• passive smoking, particularly when you are a baby
• exposure to industrial dust and chemicals
• exposure to air pollutants

Whatever the cause, smoking makes emphysema worse.

How is emphysema diagnosed?

Most people are diagnosed in their 50s, though if you have a faulty gene you may be diagnosed earlier. Your doctor can diagnose emphysema by talking to you and examining you. They may also ask for:

• blood tests
• chest x-rays
• a separate test of blood from an artery to check oxygen levels
• breathing tests to see how well your lungs work

Some people may also be asked to have:

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

How is emphysema managed?

The damage to the lungs caused by emphysema cannot be reversed, but many treatments can help manage the symptoms and improve a person’s quality of life. These treatments improve the flow of air into the lungs and by preventing complications.

Treatment is tailored to how severely the emphysema is affecting your health and your ability to do things.

Quitting smoking is the best treatment to slow the worsening of emphysema symptoms.

If you have emphysema, you may be given inhalers or tablets to help open up your airways and reduce inflammation. You may need antibiotics if you have a chest infection.

A pulmonary rehabilitation program provides exercises and education to help people with emphysema manage their breathlessness. It may include exercises to increase physical function, and knowledge about breathing techniques, how to use medication correctly and how to conserve energy.

In more severe cases, people with emphysema will need to breathe oxygen from a portable cylinder to temporarily boost oxygen levels in the blood. Very occasionally, surgery can be useful.

There are other things you can do to manage:

• eat a balanced diet
• get enough rest
• exercise regularly (speak to your doctor first)
• avoid air pollution and other people’s smoke
• get vaccinated against the flu and pneumococcal pneumonia
• have regular check-ups with your doctor

Can emphysema be prevented?

The best way to prevent emphysema is to quit smoking. Most people who develop emphysema have smoked for many years, and most long-term smokers will have some degree of emphysema.

Quitting smoking also prevents complications of emphysema.

Complications of emphysema

Emphysema can stop people from doing their daily activities, sleep or exercise. They often develop other chronic conditions such as asthma, back problems, cancer, diabetes, heart problems, stroke and kidney disease.

COPD, which includes emphysema, chronic bronchitis and chronic asthma, is the second leading cause of hospital admissions in Australia and the fifth most common cause of death.

Resources and support

Visit the Lung Foundation Australia website for more information about emphysema and COPD.

If you are trying to quit smoking, help is available via Quitline on 13 78 48.

Support for carers

Learn more about the practical, financial and emotional support and services available to carers. For carers’ services in your state or territory visit Carers Australia.

What is the difference between COPD and emphysema?

What is the difference between COPD and emphysema?

Thinking you may have emphysema or chronic obstructive pulmonary disease (COPD) can be a stressful moment of your life—especially if you aren’t sure of the difference.

Many conditions overlap between the two diseases, so finding out what you need to know is the first step to seeking the appropriate treatment.

How are they different?

Both are diseases that involve the decline of lung tissue by an irritant like nicotine smoke, which deteriorates your lung’s air sacs.

COPD is described as a chronic lung condition that worsens over time, and at one point may become emphysema or another similar ailment. Therefore, emphysema is one of many diseases that reside in the larger category of COPD.

Other disease types of COPD include asthma, chronic bronchitis, and bronchiectasis, though each may lead up to emphysema.

More than 11 million people live with COPD in the U.S. That includes more than 4 million people who have emphysema, according to the National Emphysema Foundation.

Which has worse symptoms?

Because emphysema is a late stage of COPD, the signs and symptoms are similar. If you have emphysema, you are already experiencing COPD symptoms, though earlier stages of COPD will not have as dramatic an impact as the degree of tissue degeneration is minimal.

Symptoms include respiratory difficulties that affect your breathing health, including:

• Shortness of breath (dyspnea)
• Heavy cough with some discharge
• Wheezing
• Fatigue and exercise difficulties

COPD and emphysema are measured in stages. Typically, physicians will measure your present condition by the amount of oxygen volume you effectively breathe. As symptoms worsen, your ability to intake oxygen worsens to the point you may need supplemental oxygen.

What to do next?

While there is no cure for either COPD or emphysema, there are many treatments and lifestyle changes you can make to increase and maintain your quality of life.

According to the American Lung Association, your treatments may include:

• Medications
• Supplemental Oxygen
• Surgery
• Clinical Trials
• Complementary Therapies
• Palliative Care

Please visit your doctor to understand these treatments and which one would work best for you.

In Conclusion

Essentially, emphysema is a disease that occurs in the late stages of COPD. Understanding how emphysema and COPD relate will help you get the proper treatment and improve quality of life for you or your loved one.

Want to learn more about ways to improve your health? Please keep reading our blog and be sure to share it with your friends.

Share this post

Recognizing the Early Signs of Emphysema: Northwest Pulmonary and Sleep Medicine: Pulmonary and Sleep Medicine

Emphysema is a serious lung condition most commonly caused by smoking. It makes breathing difficult and limits the amount of oxygen the bloodstream is able to transport, which can make everyday tasks more and more tiring as the disease progresses.  

While the lung damage that emphysema causes is permanent, early treatment can slow its progress and help you breathe easier. At Northwest Pulmonary and Sleep Medicine in Algonquin, Illinois, Dennis Kellar, MD, and Madhu Gundavaram, MD, and our team of providers want to help you breathe easier for longer. 

Our practice offers comprehensive care for breathing disorders, including emphysema. We’ve created this guide to help you recognize the early signs of emphysema, so you can get help as soon as possible.

What is emphysema?

Emphysema is a type of chronic obstructive pulmonary disease (COPD) in which the air sacs in your lungs become irreversibly damaged. When you breathe, the air sacs in your lungs expand and contract. With emphysema, these sacs are weakened and unable to contract. 

As more and more air sacs are affected as the disease progresses, it gets harder and harder to breathe, and your body is not able to get the oxygen it needs. With less oxygen in your bloodstream, you can become tired after doing the smallest of physical activities.  

Smoking is the most common reason people develop emphysema and is linked to 80% of all emphysema cases. Other causes include secondhand smoke, smoking marijuana, pollution, chemical fumes, and genetics. 

Currently, there’s no cure for emphysema. However, early diagnosis and intervention can stop emphysema from progressing. 

What are the early signs of emphysema?

Although catching emphysema early is key to stopping the progression of the disease, many people don’t notice symptoms until their lungs are significantly damaged. Since smoking is the No. 1 cause of emphysema, if you smoke, it’s important to pay attention to early warning signs and visit your provider for a pulmonary function test. 

Early signs of emphysema usually appear slowly, and changes in breathing can be hard to detect. Shortness of breath is usually the earliest symptom, and in the early stages, you may only notice it during or after physical activity. 

As the disease progresses, you may also notice these other early signs of emphysema:

• Wheezing
• Tightness or pain in the chest, especially after physical exertion
• A persistent or lingering cough, especially if you’re a former smoker

If you are or were a smoker and have any of these early signs, make an appointment with Northwest Pulmonary and Sleep Medicine. Early diagnosis and treatment are essential in slowing the progress of this degenerative disease. 

How is emphysema diagnosed and treated?

Your provider at Northwest Pulmonary and Sleep Medicine will first conduct a physical exam and evaluate your complete medical history. Depending on your symptoms and what your provider finds during your exam, they may also order diagnostic tests, including:

• Chest X-ray
• Bronchoscopy (with or without a biopsy)
• Thoracentesis to drain fluid in the lung
• Metabolic cart to measure oxygen use 
• Spirometry test to measure air inhaled and exhaled
• Peak flow test to measure lung capacity
• Cardiopulmonary stress test to evaluate heart and lung function 
• Six-minute walk test to measure oxygen inhalation during exertion

Treatment for emphysema begins with stopping smoking. If you’re struggling to quit, your provider may prescribe medications or counseling to help you stop. Treatment may also include prescription oxygen or medications to help you breathe. If you’re diagnosed with severe emphysema, you may need surgery. 

To learn more about emphysema or to get treatment, book an appointment online or over the phone with Northwest Pulmonary and Sleep Medicine. Are you sheltering in place? We can help with our TELEMEDICINE services that allow you to meet with us from the comfort of your own home.

Emphysema: Background, Pathophysiology, Etiology

What is Emphysema? – Revere Health

Like other organs in the body, the lungs are affected by the habits we keep in our daily lives. Everything from what we put in our bodies to the places we live and the air we breathe can have a major impact on lung health and enough negative elements here can create big problems – even for people born with perfect lungs.

One great example here is emphysema, a disease that slowly damages your lungs over time and makes it more difficult to breathe. The leading cause of emphysema? Not genetic risk or some birth defect, but smoking cigarettes. That’s right, a lifestyle choice is the primary cause of this disease.

What other factors can cause emphysema, and how is it diagnosed and treated? Here’s a breakdown.

What is Emphysema?

Emphysema is just one of a few diseases that falls under the umbrella of chronic obstructive pulmonary disease (COPD) – others include bronchitis and asthma. Patients with COPD feel shortness of breath over time, but many cases aren’t picked up for years because people think their symptoms are part of getting older.

In cases of emphysema, air sacs in your lungs called alveoli are damaged along their inner walls to the point where they rupture. Rather than many tight pockets of air like the lungs prefer, emphysema patients develop one larger pocket in the lungs as more alveoli rupture. This actually decreases the amount of oxygen that’s able to hit the bloodstream – old air is trapped when you breathe out, and new oxygen can’t get in as easily.

Shortness of breath is the number one symptom of emphysema, and often the only symptom. It usually starts out moderately before getting worse over time. If this condition becomes regular enough, it might be time to see a doctor and find out if you are suffering from emphysema. If it ever becomes so severe that you can’t complete daily tasks, or if you notice extremities like fingers or lips turning blue, call 911 or see a doctor right away.

In its worst cases, emphysema can raise the risk of life-threatening conditions like collapsed lungs, heart problems and holes in the lungs.

Causes and Risk Factors

As we mentioned earlier, smoking is the number one known cause of emphysema. It’s just one of several airborne toxins which, if inhaled over a long period of time, can cause emphysema. Here’s a full list:

• Cigarette smoke
• Marijuana smoke
• Workplace fumes (usually from warehouses and manufacturing plants)
• Pollution

These toxins are direct causes of emphysema. There are also several other general risk factors that may not directly cause the condition, but can make it more likely:

• Age – people over 40 are at higher risk, usually because their lungs have had more years to inhale harmful toxins
• All smoking – not just cigarettes, and not just one’s own smoking. Cigars, pipes, and even secondhand smoke are all risk factors
• Workplace pollution

Diagnosis Tests

There are several kinds of tests to help diagnose emphysema, split up into a few broad categories.

Lung Function Tests:

There are a few different kinds of tests available, and they help with both diagnosing emphysema and tracking its progress over time. They’re designed to measure how well your lungs are processing oxygen into the bloodstream, and usually don’t require anything other than breathing how you’re told.

Lab/Blood Tests:

In some cases, doctors will take a sample of blood and test it in a lab to see how well your lungs are sending oxygen into the bloodstream.

Imaging Tests:

Usually either a chest X-ray or a CT scan for when a single X-ray can’t pick up everything going on in the lungs.

Treatment

Depending on the severity of a case, there are a few different treatment possibilities once you’ve been diagnosed with emphysema.

• Lung rehabilitation: Generally through a combination of breathing exercises and changes to nutrition. For severe cases, some people also keep an oxygen machine at home and use it regularly
• Medication: Drugs to treat shortness of breath are often prescribed, and steroids might be an option for certain long term cases. A doctor will also prescribe antibiotics if emphysema has created an infection in the lungs
• Surgery: In severe cases, emphysema might require surgery might. Sometimes this is to remove pieces of the damaged lungs, and sometimes it’s a lung transplant

It’s important to remember that once you have emphysema, it can’t be fully cured. Treatment after diagnosis is all about managing the disease, but this is more possible than ever with the modern medicine available to us.

Revere Health Pulmonology offers specialized treatment options for asthma, COPD, chronic cough and shortness of breath.

Sources:

6 Keys to Living Well With Emphysema

One of smoking’s many adverse effects is the risk of developing emphysema and COPD, or chronic obstructive pulmonary disease.

Emphysema is one of two types of COPD; the other is chronic bronchitis. If you have emphysema, it is likely that the air sacs, or alveoli, in your lungs are damaged. As a result, your body is not getting the oxygen it needs to function properly.

“Think of COPD as a spectrum of disease, with chronic bronchitis on one end and emphysema on the other,” says Jeffrey Michaelson, MD, a pulmonologist with Piedmont Hospital in Atlanta. “COPD-related disease is most frequently caused by smoking cigarettes and first starts to manifest symptoms usually by the mid-fifties in continuous smokers.”

Telltale Emphysema Symptoms

Emphysema affects your body in many ways. Typical emphysema symptoms include having a hard time catching your breath — especially while exercising — and a chronic cough. “Symptoms of emphysema deal with progressive shortness of breath that limits activity,” says Dr. Michaelson.

Many people with emphysema also have chronic bronchitis, so an emphysema diagnosis may include chronic bronchitis symptoms as well. Chronic bronchitis brings with it the continual production of sputum associated with cough and chest congestion. Michaelson notes that the majority of patients fall somewhere in the middle of the COPD spectrum and display symptoms of both diseases.

Finding the Right Emphysema Treatment

Emphysema and COPD can’t be cured, but the right treatment can improve your emphysema prognosis as well as your overall health and well-being. Taking these steps will help:

• Get a diagnosis. If you’re unsure if you have emphysema and COPD, start by getting a diagnosis. Only then can your doctor begin to help you. “If you feel that you or someone you know over the age of 35 may be experiencing symptoms, a brief, five-question screener will help determine if that person might be at risk for COPD,” says Michaelson.
• Start emphysema treatment. Your doctor needs to be your primary source for getting a handle on emphysema treatment, says Michaelson. “It is important to seek treatment once diagnosed since COPD is a progressive disease. It can lead to frequent hospital admissions, poor quality of life, the need for supplemental oxygen, or a ventilatory assist device worn at night to help maintain effective breathing while asleep,” he says. Treatment — especially quitting smoking — along with using inhalers, helps lessen symptoms, delays disease progression, and enables patients to maintain an active lifestyle.
• Quit smoking. If you want to have a better emphysema prognosis and prevent the progression of emphysema symptoms, no step is more important than to quit smoking. “Stopping smoking reduces the inflammation and lung damage that leads to worsening of COPD and emphysema,” says Michael S. Nolledo, MD, an attending pulmonologist at the Deborah Heart and Lung Center in Browns Mills, N.J.
• Avoid other irritants. Tobacco smoke isn’t the only irritant that can exacerbate emphysema and COPD. “Most COPD in this country is related to smoking, but only 20 percent of smokers develop significant COPD,” says Byron Thomashow, MD, medical director at NewYork–Presbyterian Hospital in New York City and chairman of the COPD Foundation. “This suggests that other genetic or environmental factors must also play roles. ” Some potential irritants include cold air or poor air quality days in your region.
• Keep immunizations up to date. Michaelson says that this is a critical step for avoiding complications to emphysema and COPD. Flu and pneumonia immunizations are especially important.
• Do the right exercises. Both breathing exercises and regular cardiovascular exercise like walking are critical to curbing symptoms and having a good emphysema prognosis. Get started by doing these exercises in a program led by a trained professional before you branch out on your own. “Exercises are best managed under the guidance of a pulmonary rehabilitation program that involves not just specific exercises, but disease counseling as well,” says Dr. Nolledo. “COPD patients who complete these programs have been shown to have significant improvement in their shortness of breath.”

Because emphysema symptoms will worsen without treatment, it’s vital that you work with your doctor to manage your condition. Taking care of yourself and taking control of your symptoms will give you the best possible prognosis.

90,000 Treatment of pulmonary emphysema in Ivanovo paid admission, prices for services in the medical diagnostic center “Milenaris”

Pulmonology treats not only lung diseases, but also other organs of the respiratory system – pleura, bronchi, trachea. You need to contact a specialist in such cases:

• If you often suffer from respiratory diseases.
• If you are an experienced smoker.
• If any of your relatives have had lung disease.
• In the presence of hereditary autoimmune diseases.
• In the presence of hypertension, diabetes mellitus, heart failure.
• If you have inhaled dust, toxic gases, smoke for a long time.
• For chest injuries.
• If your work involves potentially harmful conditions for the respiratory system.

In addition, people over 45 years of age need to see a pulmonologist every year – every year.

Symptoms

Do not postpone a visit to the doctor if you have such symptoms:

• a sore throat;
• suffocating sensation;
• for dry or wet cough;
• for coughing with blood clots, lingering cough;
• if the cough is accompanied by difficult exhalation;
• for shortness of breath;
• for chest pain while breathing.
• in addition, you need to apply in case of severe weakness and fatigue, with increased drowsiness and discomfort in the throat after waking up in the morning.

Prepare to receive

No special preparation for the visit is required. The main thing is not to forget to take x-rays that were taken earlier (if any), an ECG, the results of a blood test for biochemistry, a general sputum analysis. At the appointment, wear clothing that you can easily remove and expose your chest area for examination.

How is the appointment

First, you will be asked to describe the symptoms that brought you to the appointment. Tell us how often they bother you, when exactly they appear.The doctor will ask you to describe the lifestyle itself, to clarify if you are working in potentially hazardous conditions. Also, remember if anyone in the family has had similar illnesses. / p>

This is followed by examination, listening and percussion of the respiratory organs. If necessary, you will be assigned additional tests and examinations.

Methods of treatment and diagnostics

In pulmonology, a number of diagnostic methods are used that allow you to determine the disease or clarify the diagnosis previously made.The following diagnostic methods are used:

• Laboratory – general analysis of blood and urine, analysis of sputum and secretions from the trachea and bronchi. If there is a suspicion of oncology, then a puncture is performed, followed by microdiagnostics of the tissues obtained. Laboratory tests can determine if there is inflammation, infection. Antibiotic sensitivity is also determined.
• Functional – Spirography is used to determine the degree of ventilation of the lungs.Spirography with stress tests is designed to establish what the inspiratory rate is. This helps determine if the airway is narrowed. There are also techniques that show how oxygenated the arterial blood is.
• Digital X-ray – allows you to see the structure and condition of the bronchi, lungs, blood vessels. Using this method, it is possible to establish the presence of venous stasis, tuberculosis, tumors.
• Computed tomography – is needed to clarify the diagnosis, to determine the nature of pathological changes.CT is used to determine if the tumor is benign or oncology.
• Bronchoscopy – with its help, the bronchi, trachea and larynx are examined. It is used when there is a suspicion of inflammation of the bronchi and trachea, oncology.

After carrying out all the necessary research and an accurate diagnosis, treatment is prescribed. In the process, the pulmonologist monitors the effectiveness – including with the help of diagnostic equipment.

Make an appointment with the pulmonologist at the Milenaris clinic at a convenient time for you.We will help you cope with the problem and restore your well-being!

What is emphysema of the lungs – medical.ru

Emphysema of the lungs is a pathological disease in which the alveolar part of the lungs is significantly enlarged and contains an excessive amount of a gas mixture with carbon dioxide. It occurs against the background of damage to the bronchi, destroys the structure of the lungs, impairs blood circulation. The pathology leads to an increase in intrapulmonary pressure, which causes constriction of the pulmonary artery.The heart is under significant stress, which leads to respiratory failure.

Causes of the disease

Distinguish between diffuse and bullous emphysema of the lungs. In the first case, the lung tissue is completely affected. In the second variant, the affected areas are interspersed with healthy ones. The likelihood of developing pathology is increased by the following factors:

• congenital anomalies;
• ingestion of toxic substances into the respiratory tract;
• smoking;
• disorder of microcirculation in the alveolar tissue;
• history of chronic obstructive diseases;
• acute inflammation in the bronchi;
• occupational diseases, accompanied by increased air pressure in the lungs.

Emphysema develops as an independent disease and as a complication in other pathological conditions. The disease is classified according to the degree of spread:

• panlobular;
• centrilobular;
• perilobular;
• uneven;
• bullous.

Pulmonologists distinguish McLeod’s syndrome of unknown etiology, in which only one lung is affected by pathological changes.

Emphysema of the lungs: symptoms

Irreversible destructive processes in the respiratory system are constantly progressing.This is expressed as:

• gradually increasing shortness of breath;
• asthma attacks;
• weakening of breathing;
• decrease in blood pressure indicators;
• decrease in the mobility of the diaphragm;
• tachycardia;
• heart rhythm disturbance;
• fast fatigability;
• general weakness of the body;
• headache;
• change in blood gas composition.

To make an accurate diagnosis, a general practitioner or pulmonologist conducts percussion, auscultatory listening, prescribes X-ray of the lungs, computed tomography, spirometry, peak flowmetry, clinical analysis of blood gas composition.

Treatment prospects and preventive measures

Therapy begins with the elimination of harmful factors. The patient takes medications and inhalations for the rest of his life. Hyperbaric oxygenation shows a good effect. Surgical resection of part of the lung tissue is used. If a donor is available, lung transplantation is possible to treat pulmonary emphysema.The prognosis for patients receiving adequate timely therapy is favorable. Without effective treatment, destructive processes progress, which leads to disability and disability.

It is recommended to give up smoking, perform breathing exercises, use medical oxygen masks.

treatment of the disease and methods of prevention – clinic “Dobrobut”

Emphysema of the lungs: symptoms, causes, diagnosis, treatment

Emphysema of the lungs is a pathological condition characterized by the expansion of the alveoli and destructive changes in their walls.Distinguish between primary (idiopathic) emphysema – an independent nosological form that develops without previous bronchopulmonary pathology, and secondary (obstructive), arising against the background of other respiratory diseases. The frequency of pathology increases significantly in the age group over 60 years old. The disease belongs to COPD (chronic obstructive pulmonary disease). You should know what pulmonary emphysema is and how to treat it.

Signs of pulmonary emphysema, causes of the disease

Symptoms of pulmonary emphysema:

1. Shortness of breath.At the first stage of the disease, it worries patients only with significant physical exertion. With the progression of emphysema, shortness of breath becomes permanent.
2. Cough. Usually harsh, unproductive.
3. Cyanosis. It is characteristic for patients with secondary emphysema of the lungs.
4. Weight loss. Patients are slender, may look cachectic.

Signs of pulmonary emphysema when examining a patient – a barrel-shaped chest, hyperfunctioning of the auxiliary respiratory muscles (shoulder girdle, neck, abdominal muscles).

X-ray examination reveals a low location of the dome of the diaphragm, an increase in the retrosternal (retrosternal) space (the so-called Sokolov sign), the filamentous nature of the vascular pattern. The most characteristic sign of the condition is a decrease in VC (vital capacity of the lungs) with an increase in their total capacity (OEL). The ECG shows a deviation of the electrical axis of the heart to the right. Data from laboratory studies of lung disease emphysema – an increased level of hemoglobin and the number of red blood cells.

Causes of the disease

Secondary emphysema develops due to COPD. Primary pulmonary emphysema can be caused by:

1. Ecology. Environmental pollution causes damage to the alveolar walls, which leads to the development of emphysema.
2. Smoking. Tobacco smoke causes the migration of neutrophils, which produce proteolytic enzymes that destroy the walls of the alveoli.
3. Genetically determined deficiency of alpha-1-antitrypsin, a shift towards proteolysis and damage to the alveolar walls.
4. Occupational hazardous environment, eg miners.
5. Senile age.

With bullosa emphysema, there are bullae in the tissues of the organ – swollen areas over 10 mm in size. There is also a decrease in the content of alpha-1-antitrypsin in the blood. This type of pulmonary emphysema is characterized by the development of spontaneous pneumothorax (accumulation of air in the pleural cavity).

Pulmonary emphysema: treatment

There is no specific treatment for emphysema, therefore, therapeutic programs common to all COPD are used.It is important to eliminate all the factors that caused the development of emphysema (smoking, chronic infectious process, exposure to polluted air).

Treatment of pulmonary emphysema:

1. Drugs of choice – bronchodilators: β2-adrenomimetics, m-anticholinergics, long-acting theophylline preparations.
2. Glucocorticosteroids are administered orally in short courses. In the absence of an effect, hormonal therapy is no longer prescribed. With a positive result of therapy, it is advisable to continue treatment with inhaled hormonal drugs.
3. Long-term use of acetylcysteine ​​reduces the frequency of exacerbations of COPD and, consequently, the progression of secondary emphysema.
4. Thoracoscopic bullectomy – surgical reduction of lung volume by resection of peripheral areas. After the operation, the functional state of the lungs is significantly improved.
5. With the development of spontaneous pneumothorax, the pleural cavity is drained and air removed.
6. Oxygen therapy is indicated for severe respiratory failure.
7. A group of American researchers reported that regular intake of acetylsalicylic acid (aspirin) slows the progression of emphysema and COPD.
8. Respiratory gymnastics for pulmonary emphysema is aimed at training the respiratory muscles.

Prevention consists in quitting smoking, preventing respiratory diseases, influenza vaccination, adequate therapy for chronic inflammatory diseases of the respiratory tract, improving working conditions, spa treatment of patients with COPD.Read more about the prevention of pulmonary emphysema on our website dobrobut.com.

What is emphysema of the lungs

Emphysema of the lungs is a disease in which the alveoli, which make up the lung tissue, overstretch and lose the ability to contract sufficiently, as a result of which the flow of oxygen into the blood and the removal of carbon dioxide from it is impaired. This leads to respiratory failure.

Most often, the lungs are completely affected (diffuse emphysema).Sometimes swollen areas of the lungs combine with normal lung tissue. Such areas are called bullae, and emphysema is called bullous.

Why does this happen?

The main causes of the disease are chronic bronchitis (chronic obstructive pulmonary disease) and bronchial asthma. In fact, the formation of pulmonary emphysema is a direct result of chronic bronchitis.

In the development of bullous emphysema, hereditary factors play an important role, as well as past lung diseases (for example, tuberculosis).

Smoking, air pollution with various dust particles also contribute to the development of the disease.

What’s going on?

Alveoli are microscopic “sacs” permeated with vessels, which end in the bronchi, and in which gas exchange between blood and inhaled air takes place. Normally, they swell when inhaled, filling with air, and contract when exhaling.

In emphysema, this process is disrupted. As a result of difficulty in exhaling in asthma or chronic bronchitis, air pressure in the alveoli increases, and they overstretch and become denser.Lung tissue loses its ability to dynamically stretch and collapse in response to breathing, which leads to an increase in the amount of air in the lungs. This excess air is not involved in breathing, which leads to defective lung function.

The main complaint of patients with emphysema is shortness of breath, which significantly increases with physical exertion. If the cause of the disease is heredity, then shortness of breath appears already at a young age.

Without treatment, emphysema progresses, which leads to disruption of the respiratory and cardiovascular systems.Respiratory and heart failure develops.

Bullous emphysema can proceed unnoticed, already manifesting itself as a complication – the development of pneumothorax (rupture of the bulla and air injection into the pleural cavity). This requires urgent surgical treatment.

Sources

• Cantor JO., Ma S., Liu X., Campos MA., Strange C., Stocks JM., Devine MS., El Bayadi SG., Lipchik RJ., Sandhaus RA., Turino GM. A 28-day clinical trial of aerosolized hyaluronan in alpha-1 antiprotease deficiency COPD using desmosine as a surrogate marker for drug efficacy.// Respir Med – 2021 – Vol182 – NNULL – p.106402; PMID: 33906126
• Aono K., Matsumoto J., Nakagawa S., Matsumoto T., Koga M., Migita K., Tominaga K., Sakai Y., Yamauchi A. Testosterone deficiency promotes the development of pulmonary emphysema in orchiectomized mice exposed to elastase … // Biochem Biophys Res Commun – 2021 – Vol558 – NNULL – p.94-101; PMID: 33906112
• Yang Y., Di T., Zhang Z., Liu J., Fu C., Wu Y., Bian T. Dynamic evolution of emphysema and airway remodeling in two mouse models of COPD.// BMC Pulm Med – 2021 – Vol21 – N1 – p.134; PMID: 33
  

  8

• Rademacher J., Dettmer S., Fuge J., Vogel-Claussen J., Shin HO., Shah A., Pedro PI., Wilson R., Welte T., Wacker F., Loebinger MR., Ringshausen FC. The Primary Ciliary Dyskinesia Computed Tomography Score in Adults with Bronchiectasis: A Derivation und Validation Study. // Respiration – 2021 – Vol – NNULL – p.1-11; PMID: 33895745
• Kraen M., Frantz S., Nihlén U., Engström G., Löfdahl CG., Wollmer P., Dencker M. Fibroblast growth factor 23 is an independent marker of COPD and is associated with impairment of pulmonary function and diffusing capacity.// Respir Med – 2021 – Vol182 – NNULL – p.106404; PMID: 33895626
• MacLeod M., Papi A., Contoli M., Beghé B., Celli BR., Wedzicha JA., Fabbri LM. Chronic obstructive pulmonary disease exacerbation fundamentals: Diagnosis, treatment, prevention and disease impact. // Respirology – 2021 – Vol – NNULL – p .; PMID: 33893708
• Awofisoye OI., Olalekan OE., Anumenechi N., Onwukpa F. Boerhaave’s syndrome after pentazocine-induced vomiting in a 21-year-old male with asthma: a case report.// Pan Afr Med J – 2021 – Vol38 – NNULL – p.74; PMID: 33889240
• Tezel O., Özen D. A rare case of pneumomediastinum after blown tire. // Ulus Travma Acil Cerrahi Derg – 2021 – Vol27 – N5 – p.374-376; PMID: 33884590
• Mahmoudi E., Zazove P., Pleasant T., Meeks L., McKee MM. Hearing Loss and Healthcare Access among Adults. // Semin Hear – 2021 – Vol42 – N1 – p.47-58; PMID: 33883791
• Tanabe N., Terada K., Shima H., Hamakawa Y., Shiraishi Y., Shimizu K., Sato A., Oguma T., Sato S., Hirai T. Expiratory central airway collapse and symptoms in smokers. // Respir Investig – 2021 – Vol – NNULL – p .; PMID: 33883089

Modern concept of surgical treatment of diffuse pulmonary emphysema

Pulmonary emphysema is anatomical changes in the lungs, characterized by pathological expansion of air spaces located distal to the bronchioles, and accompanied by destructive changes in the alveolar walls.

Emphysema of the lungs mainly affects chronic smokers or representatives of specialties with harmful working conditions (drivers, welders, etc.) in whom the symptoms of respiratory failure appear in middle or older age, that is, patients with chronic obstructive pulmonary disease.

Despite modern conservative therapy and rehabilitation, the quality of life and prognosis in patients with severe diffuse pulmonary emphysema remain poor, and the three-year survival rate does not exceed 60%. This forces us to look for new ways in the treatment of severe stages of diffuse pulmonary emphysema.

Currently, the number of patients with diffuse pulmonary emphysema as an outcome of chronic obstructive pulmonary disease is steadily increasing in the world, which is associated with the negative influence of harmful environmental factors and smoking.In Russia, there are about 11 million patients with chronic obstructive pulmonary disease.

Clinically diffuse emphysema is manifested by shortness of breath, unproductive cough, decreased exercise tolerance. Respiratory failure develops, eventually leading to death.

When emphysema is characterized by: shortness of breath, a barrel-shaped chest, a decrease in its respiratory excursions, widening of the intercostal spaces, swelling of the supraclavicular regions, boxed percussion sound, weakened breathing, a decrease in the area of ​​relative dullness of the heart, a low standing of the diaphragm and a decrease in its mobility, an increase in the transparency of the pulmonary fields on roentgenogram.

Primary emphysema, to a much greater extent than secondary emphysema, is characterized by severe shortness of breath (without a previous cough), with which the disease begins. Even at rest, patients have an extremely large ventilation volume, so their exercise tolerance is very low.

Known for patients with primary emphysema, the symptom of “panting” (covering the mouth opening during exhalation with swelling of the cheeks) is caused by the need to increase the intrabronchial pressure during exhalation and thereby reduce the expiratory collapse of the small bronchi, which interferes with the increase in ventilation volume.

Diagnosis of diffuse pulmonary emphysema is based on: X-ray examination, computed tomography and multispiral computed tomography of the chest organs, spirometry data (respiratory function tests), bodyplethysmography, blood gas composition, ventilation and perfusion scintigraphy.

In the early stages, when the diagnosis of diffuse emphysema is established, conservative therapy is carried out, including treatment of the underlying disease and therapy aimed at arresting respiratory and heart failure.Due to the fact that with emphysema ventilation of the lung tissue is significantly affected and the functioning of the mucociliary escalator is disrupted, the lungs become much more vulnerable to bacterial aggression.

Infectious diseases of the respiratory system in patients with this pathology often turn into chronic forms, foci of persistent infection are formed, which greatly complicates treatment. In the presence of such a pathology, special attention should be paid to antibiotic therapy of even minor respiratory infections in order to prevent their chronicity.

Modern conservative treatment does not always lead to an improvement in the quality of life and an increase in the physical endurance of patients. With an extremely severe stage of diffuse emphysema, the mortality rate within the next three years is 40%. Diffuse pulmonary emphysema is a disease traditionally treated by therapists and pulmonologists. The only radical operation for this disease can be a lung transplant, but the number of patients exceeds the real possibilities of transplantation.This forces us to look for new ways of treatment. There are various approaches to performing this type of surgery.

The experience accumulated to date in the surgical treatment of diffuse pulmonary emphysema has made it possible to outline certain criteria for selecting patients for surgery – surgical reduction of lung volume. Traditional “open” surgical approaches are used – sternotomy, lateral thoracotomy or video-assisted thoracoscopy (VATS).

Depending on the prevalence of bullous-cystic degeneration of the lung tissue, both open and endoscopic operations are performed.Open surgery (thoracotomy) is performed in cases of pronounced adhesions and with large volumes of lung tissue resection, which requires diaphragm plasty in order to reduce the volume of the residual pleural cavity.

Videothoracoscopic operations are used in all volumes. The only contraindication is the total adhesion process in the pleural cavities.

All operations for diffuse pulmonary emphysema are high-tech methods of treatment.

Since postoperative respiratory failure occurs much less frequently with VATS and less mortality is observed, VATS may be the operation of choice, especially in elderly patients.

From 20 to 40% of the most altered lung tissue is removed, which by weight is 50-100 g.

Evaluation of the effectiveness of the operations performed

Long-term observation of patients who underwent surgical reduction of lung volume shows that after surgery there is a slow decrease in the degree of shortness of breath, improvement in functional parameters, pulmonary elastic response and exercise tolerance.All this together leads to an improvement in the quality of life.

Effects of surgical reduction of lung volume in relation to functional parameters are divided into short-term (3-6 months) and long-term (1 year or more). Decompression of relatively healthy lung tissue is one of the pathogenetic mechanisms for improving lung volumes after surgery. Persistent positive results were noted after 4 years or more after the operation.

After removal of non-functioning lung volumes, secondary bronchial obstruction is eliminated at the level of small distal bronchioles, which are devoid of a cartilaginous framework.

Tambov Regional Clinical Hospital named. V.D. Babenko is the only institution in the region where surgical treatment of patients with diffuse pulmonary emphysema is performed. In the period from 2015 to 2017 in the 1st surgical department of the State Budgetary Healthcare Institution “TOKB im. VD Babenko “performed more than 30 operations on patients with various forms of diffuse pulmonary emphysema.

A multidisciplinary multilevel approach is effectively implemented using modern diagnostic and therapeutic capabilities of a multidisciplinary hospital and performing modern videothoracoscopic operations using modern high-tech, high-energy equipment and stapling endosteplers.

As a result of surgical interventions in patients with severe diffuse pulmonary emphysema, breathing mechanics are significantly improved, blood oxygen saturation and physical endurance increase, which leads to a decrease in shortness of breath, an improvement in the quality of life and enhances the effect of drug therapy.

The accumulated vast experience, continuous improvement of knowledge and skills, as well as the introduction of new techniques with the use of modern instrumentation allows successfully performing thoracoscopic operations in patients with diffuse pulmonary emphysema.

Complicated forms of bullosa emphysema of the lungs

Department of Thoracic Surgery No. 1


Bullous emphysema of the lung – limited emphysema, the morphological basis of which is air cavities (bullae) in the lung parenchyma.

In foreign pulmonology, it is customary to distinguish between blebs (English “blebs” – bubbles) – air cavities less than 1 cm in size, located in the interstitium and subpleurally, and bullae – air formations with a diameter of more than 1 cm, the walls of which are lined with alveolar epithelium.The exact prevalence of bullosa pulmonary emphysema has not been determined, but the disease is known to cause spontaneous pneumothorax in 70–80% of cases. In the literature, bullous emphysema of the lungs can be found under the names “bullous disease”, “bullous lung”, “pseudo / alveolar cyst”, “vanishing lung syndrome”, etc. The clinical picture of bullous emphysema of the lungs is determined mainly by its complications, therefore a long period time, the disease does not manifest itself in any way.Despite the fact that the bullous areas of the lung tissue do not participate in gas exchange, the compensatory capabilities of the lungs remain at a high level for a long time. If the bullae grow gigantic, they can compress the functioning parts of the lung, causing respiratory failure. Signs of respiratory failure can be determined in patients with multiple, bilateral bullae, as well as bullous disease occurring against the background of diffuse pulmonary emphysema. The most common complication of bullous disease is recurrent pneumothorax.The mechanism of its occurrence is most often due to an increase in intrapulmonary pressure in bullae due to physical exertion, lifting weights, coughing, straining. This leads to rupture of the thin wall of the air cavity with the release of air into the pleural cavity and the development of lung collapse. Signs of spontaneous pneumothorax are sharp pains in the chest with irradiation to the neck, collarbone, arm; shortness of breath, inability to take a deep breath, paroxysmal cough, forced position.

Diagnostics:

Treatment:

Anti-recurrent operations (resection of bulls, pleurectomy), including those using endovidiosurgical technologies.

Branch services and prices

Pulmonary emphysema is … What is pulmonary emphysema?

Lung emphysema (from ancient Greek ἐμφυσάω – inflate, inflate, swell) – a disease of the respiratory tract, characterized by pathological expansion of the air spaces of the distal bronchioles, which is accompanied by destructive and morphological changes in the alveolar walls; one of the most common forms of chronic nonspecific lung diseases.

Etiology

There are two groups of reasons leading to the development of pulmonary emphysema.The first group includes factors that violate the elasticity and strength of the elements of the lung structure: pathological microcirculation, changes in surfactant properties, congenital deficiency of alpha-1-antitrypsin, gaseous substances (cadmium compounds, nitrogen oxides, etc.), as well as tobacco smoke, dust particles in inhaled air. These reasons can lead to the development of primary, always diffuse emphysema. Its pathogenesis is based on pathological restructuring of the entire respiratory part of the lung; the weakening of the elastic properties of the lung leads to the fact that during exhalation and, consequently, an increase in intrathoracic pressure, small bronchi, which do not have their cartilaginous framework and lack elastic traction of the lung, passively collapse, thereby increasing bronchial resistance on exhalation and an increase in pressure in the alveoli.Bronchial permeability during inspiration with primary emphysema is not impaired.

Factors of the second group contribute to an increase in pressure in the respiratory region of the lungs and increase the stretching of the alveoli, alveolar passages and respiratory bronchioles. The most important among them is the obstruction of the airways that occurs in chronic obstructive bronchitis. This disease becomes the main reason for the development of secondary or obstructive pulmonary emphysema, since it is with it that conditions are created for the formation of a valve mechanism for overstretching of the alveoli.So, a decrease in intrathoracic pressure during inhalation, causing passive stretching of the bronchial lumen, reduces the degree of existing bronchial obstruction; positive intrathoracic pressure during expiration causes additional compression of the bronchial branches and, exacerbating the existing bronchial obstruction, contributes to the retention of inspired air in the alveoli and their overstretching. Of great importance is the spread of the inflammatory process from the bronchioles to the adjacent alveoli with the development of alveolitis and destruction of the interalveolar septa.

Pathogenesis

Centrilobular emphysema develops as a result of chronic bronchial obstruction in chronic bronchitis (bronchiolitis). Panacinar emphysema can be of the same origin with more pronounced changes or has a primary character, for example, with a deficiency of alpha-1-antitrypsin. With an increase in bronchial resistance, small branches of the bronchi are compressed, the emptying of the alveoli becomes difficult, their stretching occurs, and later the destruction of the interalveolar septa.Violation of the ratio of ventilation and blood flow leads to a decrease in the saturation of arterial blood with oxygen, the development of respiratory acidosis.

Symptoms and course of the disease

Characterized by shortness of breath, a barrel-shaped chest, a decrease in its respiratory excursions, widening of the intercostal spaces, swelling of the supraclavicular areas, boxed percussion sound, weakened breathing, a decrease in the area of ​​relative dullness of the heart, a low standing of the diaphragm and a decrease in its mobility, an increase in the transparency of the pulmonary fields on the roentgenogram.Primary emphysema, to a much greater extent than secondary emphysema, is characterized by severe shortness of breath, with which (without a previous cough) the disease begins; in patients, already at rest, the volume of ventilation is extremely large, therefore, their exercise tolerance is very low. Known for patients with primary emphysema, the symptom of “panting” (covering on expiration of the mouth opening with swelling of the cheeks) is caused by the need to increase the intrabronchial pressure during expiration and thereby reduce the expiratory collapse of the small bronchi, which interferes with the increase in ventilation.In primary emphysema, less than in secondary emphysema, the gas composition of the blood is disturbed.

Symptomatic treatment of primary emphysema

Respiratory gymnastics aimed at the maximum inclusion of the diaphragm in the act of breathing; oxygen therapy courses, exclusion of smoking and other harmful effects, including occupational; limiting physical activity. A therapy with a1-antitrypsin inhibitors is being developed. Accession of a bronchopulmonary infection requires the appointment of antibiotics.

Treatment of secondary emphysema

With secondary emphysema, treatment of the underlying disease and therapy aimed at arresting respiratory and heart failure are carried out. There are attempts at surgical treatment of focal emphysema – resection of the affected areas of the lung. Prevention of secondary emphysema is reduced to the prevention of chronic obstructive bronchitis.

Emphysema and infectious complications

Due to the fact that in emphysema ventilation of the lung tissue is significantly affected, and the functioning of the mucociliary escalator is disrupted, the lungs become much more vulnerable to bacterial aggression.

Infectious diseases of the respiratory system in patients with this pathology often turn into chronic forms, foci of persistent infection are formed, which greatly complicates treatment. In the presence of such a pathology, special attention should be paid to antibiotic therapy of even minor respiratory infections in order to prevent their chronicity.

See also

References

Notes

.