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Emphysema: Meaning, Types, Stages, Symptoms, Causes, Treatment

Emphysema is primarily a pathological diagnosis that affects the air spaces distal to the terminal bronchiole. Check this article to know more about the Emphysema.
authorImageJasdeep Bhatia17 Apr, 2024
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Emphysema

If you are looking for Emphysema, you have come to the right place!

The topic “Emphysema” will be covered in this article. Emphysema is a chronic lung disease that damages lung tissue gradually over time, particularly the alveoli (tiny air sacs). Gradually, as a result of this injury, the air sacs burst, forming one large air pocket instead of numerous smaller ones. Because of the decreased lung surface area, the air is trapped in the injured tissue, which prevents oxygen from reaching the bloodstream. This obstruction also slowly overfills the lungs, making breathing harder and more challenging. This article will discuss the types, stages, symptoms, causes, complications, signs and treatment of Emphysema.

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What is Emphysema?

Emphysema, an ailment of the lungs, causes difficulty in breathing. Alveoli, the lungs' air sacs, suffer damage in those with emphysema. The air sacs' inner walls deteriorate and tear over time, resulting in fewer, more significant air gaps as opposed to more smaller ones. As a result, less oxygen enters your bloodstream because of a reduced lung surface area. Inflammation of the bronchial tubes, which deliver air to your lungs, results in chronic bronchitis and a protracted cough. The leading cause of COPD is smoking. Treatment for COPD may slow the progression of the condition but cannot reverse the damage.

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Types of Emphysema

Emphysema has four primary forms, three unrelated to fibrosis and based on the lung's lobule structure: centrilobular or centriacinar, panlobular or panacinar, and paraseptal or distal acinar (scarring). Although fibrosis is not a specific aspect of these subtypes, end-stage emphysema repair techniques can result in lung fibrosis. The acinus, also called paracicatricial or irregular emphysema, is irregularly affected by the fourth subtype and is linked to fibrosis.

Centrilobular

The initial respiratory bronchiole, the terminal bronchiole, and the area around them all affect centrilobular emphysema, also known as centriacinar emphysema. On imaging, this condition appears as a region around the visible pulmonary artery's tip. The most prevalent kind, centrilobular emphysema, is frequently linked to smoking and chronic bronchitis. The lung parenchyma in the perilobular area is unaffected, while the disease spreads from the centrilobular zone. Typically, the damaged lung lobes are the upper lobes.

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Panlobular

All of the alveoli in a lobule, are affected by panlobular emphysema, also known as panacinar emphysema, which can affect the entire lung or primarily the lower lobes. This emphysema is unrelated to smoking and is linked to alpha-1 antitrypsin deficiency (A1AD or AATD) and Ritalin lung.

Paraseptal

Emphysematous changes close to a pleural surface or a fissure are paraseptal emphysema, also known as distal acinar emphysema. In paraseptal emphysema, cystic pockets called blebs or bullae usually develop in just one layer underneath the pleura. This sets it apart from the fibrosis' honeycombing of tiny cystic areas, usually in layers. There is no link between this kind of emphysema and airflow blockage.

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Paracicatricial

Large voids are next to patches of fibrosis (scarring), also called paracicatricial or irregular emphysema. Most frequently, silicosis, granulomatous infection, tuberculosis, or pulmonary infarction cause scarring. It can be challenging to distinguish from pulmonary fibrosis honeycombing.

Stages of Emphysema

COPD is divided into four stages by the Global Initiative for Chronic Obstructive Lung Disease (GOLD). COPD is brought on by emphysema, although not all emphysema patients also have COPD. Emphysema is described in terms of the COPD stages by medical professionals. They are as follows:
  • Stage 1: Emphysema's mildest stage. Compared to the healthy lungs of someone of the same age, height, and sex, your lungs perform at least 80% as well.
  • Stage 2: Emphysema of mild severity. Your lungs function between 50% and 79%,compared to the healthy lungs of a person your age, height, and sex.
  • Stage 3: This emphysema is severe. Your lungs function between 30% and 49%, compared to the healthy lungs of a person your age, height, and sex.
  • Stage 4: This emphysema is severe. When compared to the healthy lungs of someone of the same age, height, and sex, your lungs perform less than 30% as well.

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Symptoms of Emphysema

Emphysema's early symptoms can differ from person to person.
  • A cough (with or without sputum), wheezing, rapid breathing, shortness of breath with effort, and tightness in the chest are among the symptoms that might occur.
  • There can be a lot of flu or cold infections. Anxiety, despair, exhaustion, restless sleep, and weight loss are possible additional symptoms.
  • Emphysema is frequently underdiagnosed because these symptoms could be related to other lung diseases or health issues.
  • Emphysema-related breathlessness can worsen over time and become chronic obstructive pulmonary disease.

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Causes of Emphysema

Emphysema is primarily brought on by smoking. In addition to damaging lung tissue, cigarette smoke irritates your airways. Cigarette smoke destroys your cilia and inflames your body. Swollen airways, mucus production, and trouble clearing your airways are all symptoms of irritation and damaged cilia. Emphysema has several causes, but smoking is the main one. These consist of
  • Marijuana
  • Vaping and e-cigarettes.
  • Cigar smoke.
  • Air pollution.
  • Dust.
  • Chemical fumes.

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Risk Factors of Emphysema

Your risk of acquiring emphysema is influenced by the following factors:
  • Smoking . Smokers of cigars and pipes are also prone to developing emphysema, although cigarette smokers are likelier to do so. The risk rises with time and tobacco consumption for all categories of smokers.
  • Age . Emphysema symptoms often begin between the ages of 40 and 60, even though the lung damage takes time to manifest.
  • Exposure to secondhand smoke. Secondhand smoke, sometimes called passive or environmental tobacco smoke, is smoke from another person's cigarette, pipe, or cigar that you unintentionally breathe in. Your chance of developing emphysema increases when secondhand smoke is present.
  • Occupational exposure to fumes or dust. You are more prone to get emphysema if you breathe in chemical fumes or dust from grain, cotton, wood, mining goods, or both. If you smoke, the danger is significantly more severe.
  • Exposure to indoor and outdoor pollution. You risk developing emphysema if you breathe indoor and outdoor contaminants, such as car exhaust and fumes from heating fuel.

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Complications of Emphysema

Patients with emphysema are also more likely to:
  • Collapsed lung (pneumothorax). Due to the substantial impairment in the function of their lungs, people with severe emphysema risk dying from a collapsed lung.
  • Heart problems. The pressure in the arteries from the heart to the lungs may rise due to emphysema. This may lead to cor pulmonale, a disorder where a section of the heart enlarges and weakens.
  • Large holes in the lungs (bullae). Some emphysema patients have bullae, or lungs with empty spaces. They can be as big as one lung's worth. Giant bullae limit the lung's ability to expand and raise the possibility of developing a pneumothorax.

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How is Emphysema diagnosed?

Your healthcare practitioner can identify emphysema. Emphysema cannot be identified purely by your symptoms, though. A physical examination will be done by your healthcare professional. They will use a stethoscope to listen to the sounds of your lungs during the physical examination (auscultation). A stethoscope is a medical instrument with an earpiece and a tiny metal disc (diaphragm) connected by rubber tubing. Your healthcare professional will tap your chest while holding a stethoscope against it and listen for a hollow sound. If they hear a hollow sound, it indicates that air is trapped in their lungs. After that, they will request tests to confirm emphysema.

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Treatment of Emphysema

Emphysema can get worse over time. Therefore the goal of treatment is to minimise its progression while maximising the function of the healthy lung you still have. Your emphysema's severity will determine the sort of treatment you receive.

Treatment options could be:

  • Quitting Smoke: Quitting smoking is the best method to decrease the progression of emphysema. The most crucial action you can take to safeguard your lungs is this. You and your healthcare professional can identify the most efficient ways to stop smoking.
  • Bronchodilators : The muscles around your airways are relaxed by these drugs. When these muscles are relaxed, your lungs can breathe in and out more air. In comparison to oral drugs, they work faster and better. Asthma and other lung disorders can be treated using bronchodilators.
  • Inhaled corticosteroids: Inhaled corticosteroids lessen mucus production and airway oedema. To help avoid the symptoms of emphysema, you might need to take inhaled corticosteroids daily.
  • Oxygen therapy: Oxygen treatment can help if your lungs aren't supplying enough oxygen to your blood (hypoxemia). You'll receive additional oxygen from a machine via a facemask or a nasal catheter. Your healthcare practitioner will attach a flexible tube called a nasal catheter (also known as a nasal cannula) to your nose.
  • Lung transplant: A lung transplant replaces your damaged lungs with healthy lungs from a donor if you have severe emphysema and your lungs don't respond to conventional forms of treatment.

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Key Facts About Emphysema
  • More than three million Americans have emphysema, which has been diagnosed as a disease.
  • Emphysema is one of the most avoidable respiratory conditions due to its close association with smoking. Smoking is the leading cause, but other factors like respiratory infections, air pollution, and a lack of alpha-1 antitrypsin can also contribute.
  • Emphysema signs and symptoms take time to manifest, but once they do, they typically include chest tightness, wheezing, coughing up mucus, and shortness of breath.
  • Chest X-rays, pulse oximetry, spirometry, other pulmonary function tests, an arterial blood gas test, and an electrocardiogram are among the procedures required to identify emphysema (ECG).
  • Emphysema cannot be cured. However, numerous treatments can help manage its symptoms. Oxygen treatment can aid people who need help breathing. Bronchodilator medicines can relax the muscles and minimise airway inflammation.

Emphysema <span style=

Which bodily area is emphysema most likely to affect?

Alveoli, the lungs' air sacs, suffer damage in those with emphysema.The inner membranes of the air sacs deteriorate and rupture over time, producing fewer, larger air gaps as opposed to many, smaller ones.As a result, less oxygen enters your bloodstream because of a reduced lung surface area.

How long does emphysema persist without treatment?

Emphysema has a bad prognosis and an average life expectancy of roughly five years because most patients aren't diagnosed until stage 2 or 3. Emphysema progression can be significantly slowed down by treatment and early detection.

Which enzyme causes emphysema?

An intracellular, granule-associated enzyme known as neutrophil elastase can cause emphysema in experimental mice and is blocked by 1-antitrypsin.

What is the most effective emphysema treatment?

Pulmonary rehabilitation, which involves education, nutrition counselling, learning specific breathing methods, assistance with quitting smoking, and beginning an exercise routine, is a crucial component of treating emphysema.

What results in emphysema death?

In advanced COPD, respiratory failure is thought to be the main cause of death. Major contributing factors and the main causes of death in mild-to-moderate COPD are comorbidities such as cardiovascular disease and lung cancer.
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