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Emphysema

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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

George Schiffman, MD, FCCP

George Schiffman, MD, FCCP

Dr. Schiffman received his B.S. degree with High Honors in biology from Hobart College in 1976. He then moved to Chicago where he studied biochemistry at the University of Illinois, Chicago Circle. He attended Rush Medical College where he received his M.D. degree in 1982 and was elected to the Alpha Omega Alpha Medical Honor Society. He completed his Internal Medicine internship and residency at the University of California, Irvine.

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Emphysema facts

• Emphysema is a destructive disease of the lung in which the alveoli (small sacs) that promote oxygen exchange between the air and the bloodstream are destroyed.
• Smoking is the primary cause of emphysema, which makes it a preventable illness.
• There are also less common genetic causes of emphysema including alpha-1 antitrypsin deficiency
• Shortness of breath is the primary symptom of emphysema. It is a progressive complaint, worsening over time. Early in the disease, shortness of breath may occur with exercise and activity but symptoms gradually worsen and may occur at rest.
• Diagnosis of emphysema is based upon history, physical examination, and pulmonary function studies.
• Once present, emphysema is not curable, but its symptoms are controllable.
• Medication regimens are available to preserve function for daily activities and quality of life for an individual with emphysema.
• Oxygen supplementation may be required for a person with emphysema.
• Exercise training and education are essential components of emphysema therapy and pulmonary rehabilitation.
• Surgical options for individuals with emphysema have been developed and but are not expected to be available for widespread use.
• Emphysema does not affect quantity of life, but rather quality of life. There are no studies that can predict life-expectancy in individuals with emphysema.

Introduction to emphysema

The lungs are a pair of organs in the chest that are primarily responsible for the exchange of oxygen and carbon dioxide between the air we breathe and the blood.

The lung is composed of clusters of small air sacs (alveoli) divided by thin, elastic walls or membranes. Capillaries, the tiniest of blood vessels, run within these walls between the alveoli and allow blood and air to come near each other. The distance between the air in the lungs and the blood in the capillaries is very small, and allows molecules of oxygen and carbon dioxide to transfer across the membranes.

Air reaches the alveoli via the bronchial tree. The trachea splits into the right and left mainstem bronchi, which branch further into bronchioles and finally ends in the alveolar air sacs.

When we breathe in, air enters the lung and the alveoli expand. Oxygen is transferred onto hemoglobin molecules in the red blood cells to be transported to the rest of the body for use. As oxygen attaches to the red blood cell, carbon dioxide, the waste product of metabolism, detaches and crosses into the alveoli to be exhaled. When we breathe out, the alveoli get squeezed by the elasticity in their walls and air is pushed out of the lungs.