What are the First Symptoms of Emphysema?

Reviewed on 12/10/2020

What is emphysema?

Emphysema is a chronic lung disease that makes breathing difficult. Early symptoms include difficulty breathing, persistent cough, extreme fatigue, and more. Learn about other warning signs symptoms, causes, diagnose, and treatment options.
Emphysema is a chronic lung disease that makes breathing difficult. Early symptoms include difficulty breathing, persistent cough, extreme fatigue, and more. 

Emphysema is a chronic lung disease that damages the alveoli, or small air sacs, in the lung. These air sacs are normally stretchy and elastic. They inflate when you inhale and deflate as you exhale. Emphysema, also called pulmonary emphysema, damages the alveoli, making it difficult for your lungs to absorb oxygen and release carbon dioxide. This leads to breathing problems, coughing, and fatigue

Chronic bronchitis and emphysema are the two main types of chronic obstructive pulmonary disease (COPD). Some people may have both forms of COPD simultaneously, but the severity varies from person to person. 

Emphysema is a common condition, affecting more than three million people in the United States each year. 

Signs & symptoms of emphysema

Emphysema symptoms are typically mild at first and include:

  • Breathing problems
  • Coughing 
  • A persistent cough with some phlegm 

They become more severe as the disease progresses. You'll typically notice: 

  • Breathing difficulties
  • Extreme fatigue
  • A feeling of "choking" while lying down
  • An enlarged chest 
  • A hacking cough that produces bloody mucus

People with emphysema are more likely to develop respiratory infections like colds and seasonal flu. Severe emphysema may cause weight loss, muscle weakness, and swelling in your legs, feet, and ankles. 

Causes of emphysema

Air pollution and respiratory infection may play a part in the development of emphysema, but the medical community considers smoking the number one cause. The disease develops slowly over time. 

The most common triggers are: 

  • Smoking
  • Exposure to cold weather or rapid temperature changes 
  • Air pollution, including dust, vapors, gases, chemical fumes, and other toxic substances 
  • Indoor pollution from burning wood, smoke, heating fuels, environmental dust, and secondhand cigarette smoke
  • A rare genetic form of the disease called alpha 1-antitrypsin deficiency-related pulmonary emphysema (AATD) or early-onset pulmonary emphysema. It's recommended that all patients diagnosed with COPD receive a screening for AATD at least once. 

Diagnosing emphysema

If you're experiencing a chronic cough, are concerned about your lung infection, or have already been diagnosed with COPD, you'll need to make an appointment with your doctor. Be prepared for a thorough physical exam, and expect to spend some time discussing your medical history and symptoms you're experiencing. 

Diagnosing emphysema requires a series of breathing tests and medical scans, including: 

Pulmonary function testing (PFT)

Pulmonary function testing measures the flow and volume of air as you breathe. Your doctor will ask you to perform a series of breathing maneuvers to assess your lung function. 

High-resolution computed tomography (HRCT) 

An HRCT scan is a specific type of CT scan that takes high-resolution images to see what's happening inside your body. You'll lie on a table while a machine scans your chest cavity and provides images of your lungs. 

Chest x-ray

A series of x-rays taken from different angles will help your doctor rule out other lung diseases and confirm the emphysema diagnosis. 

Arterial blood gases analysis 

Emphysema can prevent the lungs from transferring the proper amount of oxygen to your bloodstream and removing carbon dioxide. These blood tests will confirm just how far the disease has progressed. 

Sputum exam

Sputum is a gooey substance that you cough up when you have a lung infection. It usually contains bacteria, viruses, smoke, or other pollutants. A doctor may take a sample of this goo to determine the cause of your lung problems. 

QUESTION

COPD (chronic obstructive pulmonary disease) is the same as adult-onset asthma. See Answer

Treatments for emphysema

There's no cure for emphysema or a way to repair or regrow damaged lung tissue. However, it's possible to live more comfortably with the disease. Treatment options focus on controlling current symptoms and preventing them from getting worse. 

Treatments may include : 

  • Quitting smoking and avoiding secondhand smoke
  • Removing other air pollutants from your workspace and home
  • A pulmonary rehab program, which includes exercises to strengthen the muscles you use for breathing 
  • Oral or inhaled bronchodilators, which are medications that widen the airways in your lungs 
  • Oral or inhaled prescriptions to treat coughing and wheezing 
  • Annual vaccines for influenza and pneumonia 
  • Nutritional support to keep the body strong and help maintain your weight 
  • Oxygen therapy
  • Surgery to remove damaged lung tissue 
  • Lung transplant  

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References
American Lung Association: "Emphysema."

Beth Israel Lahey Health Winchester Hospital: "Emphysema."

Cedars Sinai: "Pulmonary Emphysema."

Johns Hopkins Medicine: "Pulmonary Emphysema."

MedlinePlus: "Emphysema."

University of San Francisco Health: "Emphysema Diagnosis."

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