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Emphysema

Emphysema

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Published by: Khalid Mahmud Arifin on Jun 27, 2008
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01/12/2013

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Emphysema
Definition
 
Emphysema is alung diseasethat involves damage to the air sacs (alveoli) in the lungs. The air sacs are unable to completely deflate, and are therefore unable to fill with fresh air to ensureadequate oxygen supply to the body.
Causes, incidence, and risk factors
 
Cigarette smoking is the most common cause of emphysema. Tobacco smoke and other pollutants are thought to cause the release of chemicals from within the lungs that damage thewalls of the air sacs. This damage becomes worse over time, affecting the exchange of oxygenand carbon dioxide in the lungs.A naturally occurring substance in the lungs called alpha-1 antitrypsin may protect against this damage. People withalpha-1 antitrypsin deficiencyare at an increased risk for this disease.
Symptoms
 
Chroniccough with or without sputum production
Decreased ability to exerciseAdditional symptoms that may be associated with this disease include the following:
Signs and tests
 
Aphysical examinationmay show wheezing, decreased breath sounds, or prolonged exhalation (exhalation takes more than twice as long as inspiration). The chest may be barrel-shaped. Theremay be signs of chronically insufficient oxygen levels in the blood.These tests help confirm the diagnosis:
Arterial blood gasesshowing low levels of oxygen in the blood (hypoxemia), and highlevels of carbon dioxide (respiratory acidosis)This disease may also alter the results of the following tests:
 
Treatment
 
Smoking cessation is the most important and effective treatment. Only quitting smoking can stopthe progression of lung damage once it has started. Medications used to improve breathinginclude bronchodilators (hand-held inhaler or nebulizer), diuretics, and corticosteroids. Antibioticsmay be prescribed whenrespiratoryinfections occur.Influenza(flu) vaccines and Pneumovax (pneumonia vaccine) are recommended for people with emphysema.Low-flow oxygen can be used during exertion, continuously, or at night. Pulmonary rehabilitationcan improve exercise tolerance and quality of life in the short-term. Lung transplantation is anoption for patients with severe disease.Carefully selected patients may be eligible for lung reduction surgery. This procedure removes thedamaged portions of the lung, which allows the normal portions of the lung to expand more fullyand take advantage of increased aeration. When successful, those who undergo the surgeryreport improvement in walking distance and quality of life.
Support Groups
 
Contact theAmerican Lung Association for a support group near you.
Expectations (prognosis)
 
The outcome is better for patients with less damage to the lung. Prognosis is largely determinedby initial shortness of breath, exercise tolerance, and results fromlung function tests(spirometry).Death may occur from respiratory failure, pneumonia, or other complications.
Complications
 
Recurrent respiratory infections
Cor pulmonale(enlargement and strain on the right side of the heart)
Erythrocytosis (increased red blood cell count)
Death
Calling your health care provider 
 
Call your health care provider if you develop symptoms of emphysema.If you know you have emphysema, call your health care provider if  breathing difficulty, cough, sputum production or fever develops or changes.
Prevention
 
Avoiding smoking -- or quitting if you do smoke -- can greatly decrease risk for this disease.
 

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