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Emphysema (cont.)

What Are Emphysema Symptoms and Signs?

Shortness of breath is the most common symptom of emphysema. Cough, sometimes caused by the production of mucus, and wheezing may also be symptoms of emphysema. You may notice that your tolerance for exercise decreases over time. Emphysema usually develops slowly. You may not have any acute episodes of shortness of breath. Slow deterioration is the rule, and it may go unnoticed. This is especially the case if you are a smoker or have other medical problems that limit your ability to exercise.

One of the hallmark signs of emphysema is "pursed-lipbreathing." The person with emphysema struggles to exhale completely, in an attempt to empty trapped air. They purse their lips, leaving only a small opening. Then, when they exhale, the lips block the flow of air, increasing pressure in the collapsed airways, and opening them, allowing the trapped air to empty.

People with emphysema may develop a "barrel chest," where the distance from the chest to the back, which is normally less than the distance side to side, becomes more pronounced. This is a direct result of air becoming trapped behind obstructed airways.

When to Seek Medical Care and Who to See

If you have new or worsening shortness of breath, seek medical attention from your doctor and pulmonologist. Shortness of breath can occur with other diseases, particularly heart disease and other lung diseases, so it is important not to overlook or minimize this symptom. A gradual decrease in the ability to exercise or perform daily activities, a persistent cough, and wheezing also suggest a visit to the doctor.

Because cigarette smoking is such a dangerous risk factor for emphysema, you may also wish to contact your doctor for help with making a plan to quit smoking, even in the absence of shortness of breath or other symptoms. Doctors can offer you many options to help you stop smoking. The support from a doctor may make the process easier than doing it alone. Many recent studies have shown that up to 25% of smokers may have COPD and not know it.

Shortness of breath should always be taken seriously, especially if it comes on suddenly or if it gets worse over a relatively short period of time; this situation is usually considered a medical emergency so medical care should be sought immediately.

  • If you know you have emphysema, go to the hospital's emergency department with any new, severe, or worsening shortness of breath. The inability to speak in full sentences may be a sign of shortness of breath.
  • Any hint of the lips, tongue, fingernails, or skin turning a shade of blue should prompt a visit to the hospital's emergency department. This sign, called cyanosis, can indicate severe worsening of your lung condition.
  • The failure of shortness of breath to improve or worsening shortness of breath in spite of home medications can indicate the need for emergency department care.
  • A new or worsening cough can be a sign of an infection, such as pneumonia, and should prompt a timely visit to a primary care physician or a hospital's emergency department for evaluation. Increased sputum production may also be a sign of infection. Infections make emphysema worse and can lead to long-term problems.

How to Test for Emphysema

When a doctor suspects you have emphysema, based on your complaints, a physical examination will be performed. The doctor will pay particular attention to your breathing sounds, your heart sounds, and your general physical appearance. A number of tests may be ordered or performed in the office or in the Emergency Department. These tests serve to clarify the extent of the disease, the remaining lung function, and the presence of lung infections.

  • A chest X-ray helps the doctor to identify changes in your lung that may indicate emphysema. The X-ray also may show the presence of an infection or a mass in the lung (such as a tumor) that could explain your symptoms. Shortness of breath has many causes. The chest X-ray is considered by most doctors to be the quickest and easiest test to begin to separate the different possible causes and formulate a diagnosis.
  • Lung function tests can give the doctor specific information about how the lungs work mechanically. These tests involve having you breathe into a tube that is connected to a computer or some other monitoring device, which can record the necessary information. The tests measure how much air your lungs can hold, how quickly your lungs can expel air during expiration, and how much reserve capacity your lungs have for increased demand, such as during exercise.
  • If you have a family history of alpha-1-antitrypsin deficiency, the doctor may wish to send a blood test to evaluate for this genetic disease.
  • Blood tests may also be used to check your white blood cell count, which can sometimes indicate an acute infection. This information can be used with the chest X-ray to evaluate for pneumonia, bronchitis, or other respiratory infections that can make emphysema worse.
  • Another blood test that may be helpful, especially in the hospital setting, is called the arterial blood gas. This test helps doctors determine how much oxygen and carbon dioxide are in your blood.
Medically Reviewed by a Doctor on 11/17/2017

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Emphysema »

The word emphysema is derived from Greek and means "to blow into," hence "air containing" or "air inflated."

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