Emphysema

Breathlessness is a symptom of the lung disease emphysema. Alveoli, the lungs' air sacs, suffer damage in those with emphysema. The air sacs' inner walls deteriorate and tear with time, resulting in the creation of fewer, bigger air gaps as opposed to more, smaller ones. As a result, less oxygen enters your bloodstream because of a reduction in lung surface area.

Old air becomes retained during exhalation because the injured alveoli are unable to function effectively, blocking the passageway for new, oxygen-rich air.

The majority of emphysema sufferers also have chronic bronchitis. Inflammation of the bronchial tubes, which deliver air to your lungs, results in chronic bronchitis and a protracted cough.

The two diseases that make up chronic obstructive pulmonary disease are emphysema and chronic bronchitis (COPD). The main cause of COPD is smoking. COPD treatment may halt the disease's course, but it cannot undo the harm.

Emphysema: Causes

Emphysema is brought on by long-term, considerable exposure to noxious gases, the most frequent of which is smoking cigarettes. 80% to 90% of individuals with COPD are found to be smokers, and 10% to 15% of smokers go on to acquire COPD. Yet, with smokers, the severity of smoking, the length of exposure, and baseline lung function all affect the symptoms. After using at least 20 packs of cigarettes each year, symptoms often appear.

The usage of biomass fuels and other environmental toxins like sulfur dioxide and particulate matter are acknowledged as significant factors in developing nations that have a significant negative impact on women and children.

Emphysema and anomalies of the liver can also result from a rare inherited autosomal recessive condition called alpha one antitrypsin deficiency. Nevertheless, it barely affects 1% to 2% of COPD patients. It is a risk factor and can manifest as pan-acinar bibasilar emphysema in infancy.

Allergies, lung infections, and passive smoking are other etiological variables. Furthermore, having a low birth weight as a baby increases the risk of developing COPD in later life.

Emphysema: Symptoms

Emphysema can be present for many years without any symptoms or indicators being present. Breathlessness is the primary symptom of emphysema, and it often develops gradually.

Because you could begin to avoid activities that make you feel out of breath, the symptom might not be a concern until it starts to interfere with everyday activities. Shortness of breath inevitably develops, even while you're at rest.

When to Visit a Doctor?

If you've experienced unexplained shortness of breath for a while, especially if it's growing worse or interfering with your normal activities, consult a doctor. Do not dismiss it by telling yourself that you are becoming older or out of shape. Immediately seek medical help if −

• You can't climb stairs because you are out of breath.

• As you strain yourself, your lips or fingernails turn blue or grey.

• You lack mental clarity

Emphysema: Risk Factors

Several factors play an important role in the development of emphysema which includes −

• Smoking. Smokers of cigars and pipes are also prone to developing emphysema, although cigarette smokers are more likely to do so. The risk rises with time and tobacco consumption for all categories of smokers.

• Age. Emphysema symptoms often appear between the ages of 40 and 60, although the lung damage that results from the illness develops gradually.

• Exposure to passive smoking. Second-hand smoke, sometimes referred to as passive or ambient tobacco smoke, is smoke from another person's cigarette, pipe, or cigar that you unintentionally breathe in. The chance of developing emphysema increases when second-hand smoke is present.

• Exposure to dust or fumes at work. 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 higher.

• Exposure to pollutants both indoors and outside. You run a higher risk of developing emphysema if you breathe both indoor and outdoor contaminants, such as automobile exhaust and fumes from heating fuel.

Emphysema: Diagnosis

The diagnosis of emphysema is mainly done based on history and some of the tests may be required for confirmation and to rule out underlying causes

Imaging Exams

An X-ray of the chest can rule out other potential causes of breathlessness and support the diagnosis of advanced emphysema. Yet if you have emphysema, the chest X-ray may also reveal normal results.

To create cross-sectional views of internal organs, computerized tomography (CT) scans combine X-ray images taken in many different directions. Emphysema can be identified and diagnosed with the use of CT scans. If you are a candidate for lung surgery, you could also get a CT scan.

Laboratory Tests

To find out how successfully your lungs carry oxygen into and out of your circulation, blood can be drawn from an artery in your wrist and examined.

Emphysema: Treatment

The treatment is based on the severity of the symptoms. Your doctor may advise conservative or surgical treatment.

Conservative Treatment

Your doctor may advise the following medications, depending on the severity of your symptoms −

• Bronchodilators. By relaxing restricted airways, these medications can aid with coughing, shortness of breath, and breathing issues.

• Oral steroids. Aerosolized corticosteroid medications can assist to ease shortness of breath by reducing inflammation.

• Antibiotics. Antibiotics are useful if you have a bacterial illness, such as acute bronchitis or pneumonia.

Surgical Treatment

Your doctor may recommend one or more of the following surgeries, depending on the severity of your emphysema −

• Surgery to reduce lung capacity. With this surgery, doctors cut little wedges out of the lung tissue that is damaged. The remaining lung tissue expands and functions more effectively after the unhealthy tissue is removed, which improves breathing.

• Transplanting a lung. If previous treatments have failed and you have serious lung disease, lung transplantation may be an alternative.

Emphysema: Prevention

Avoid inhaling second-hand smoke and stop smoking to prevent emphysema. If you are exposed to chemical fumes or dust at work, use a mask to protect your lungs.

Conclusion

A pulmonologist, internist, pharmacist, dietician, social worker, respiratory therapist, primary care provider, and thoracic surgeon make up the interprofessional team that manages emphysema. Emphysema has no known remedy, hence the root cause must be addressed. This includes informing the patient of the dangers of smoking and encouraging them to have the yearly influenza vaccination.

The majority of patients have a doubtful prognosis and a poor quality of life due to recurrent flare-ups and remissions of acute respiratory distress. Some people may get recurrent pneumothoraces, which may require treatment from a thoracic surgeon. There are several different lung volume reduction techniques, but they come with substantial risks, major side effects, and extended intensive care.

Pharmacists must evaluate prescriptions, look for interactions, and emphasize to patients and their families the value of compliance. In addition to monitoring and educating patients, nurses should update the team on any status changes.