Emphysema is a Chronic Obstructive Pulmonary Disease where the irreversible enlargement of the airspaces distal to the terminal bronchiole leads to airflow limitation in the lungs.Emphysema
is an irreversible enlargement of the airspaces distal to the terminal bronchiole, accompanied by destruction of their walls and no fibrosis.
Emphysema can be described at a type of Chronic Obstructive Pulmonary Disease or COPD
. COPD is a preventable lung disease with effects observed outside the lungs too. It causes airflow limitation in the lungs which is not fully reversible. Beside emphysema, COPD also includes chronic bronchitis.
Emphysema is caused by reactive oxygen species or free radicals that are released from cigarette smoke
or inflammatory cells.
These damage the lung tissue and result in loss of elastic recoil of the lung, thereby causing emphysema.
Risk factors for emphysema include:Environmental Factors
1. Smoking - Cigarette smoking
is the major cause for mortality from chronic bronchitis and emphysema. Passive and second hand smoking exposure is also a risk factor as it can compromise lung capacity.
2. Air Pollution
in urban areas and biomass solid fuel fires like wood, animal dung and coal in rural areas leading to indoor pollution.
3. Occupational exposures like in coal miners, people working with cadmium
4. Low birth weight
which can decrease maximally attained lung function in life later
5. Childhood infections and infections with adenovirus, HIV
6. Low socioeconomic status
7. Nutritional deficiencies
8. Cannabis smoking Host Factors
1. Genetic causes like alpha 1 antitrypsin deficiency
2. Airway hyperactivity.
Symptoms and signs depend on the severity of the emphysema. The patient may experience breathlessness, cough with expectoration and weight loss.
Tests used in the diagnosis and estimation of the severity of emphysema include chest x-ray
, and other imaging studies, spirometry, estimation of arterial blood gases, and assay of enzymes that may be associated with emphysema.
Treatment of emphysema involves medications like bronchodilators and corticosteroids, and oxygen therapy. Surgical treatment or palliative care may be necessary in some cases.
All patients should be advised to quit smoking