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What is emphysema?

Emphysema is a long-term lung disease. Emphysema is part of a group of lung diseases called chronic obstructive pulmonary disease (COPD). Emphysema damages the alveoli in your lungs. This makes it hard for your lungs to send oxygen to the rest of your body.

What causes emphysema?

You are at higher risk of emphysema if you have had other lung conditions such as asthma and tuberculosis. Emphysema is most commonly caused by exposure to the following:

  • Tobacco smoke, including secondhand smoke

  • Dust, chemicals, or smoke used in the workplace

  • Air pollution

What are the signs and symptoms of emphysema?

Your signs and symptoms may develop over time. You may not notice them until they start to interfere with your daily activities.

  • Shortness of breath that gets worse with exercise

  • Chronic cough

  • Chronic production of mucus

  • Wheezing

  • The need to lean forward to breathe when you are sitting

  • A bluish tint to your skin, lips, or nails

How is emphysema diagnosed?

Your caregiver will ask about your symptoms and examine you. He will ask if you smoke or are exposed to smoke, air pollution, dust, or chemicals.

  • Blood tests: Your blood is tested for the amount of oxygen, acids, and carbon dioxide it contains. This is also called an ABG test.

  • Chest x-ray: This is a picture of your lungs and heart. Caregivers use the x-ray to look for damage to your lungs.

  • Spirometry: A spirometer measures how well you can breathe. You will take a deep breath and then push the air out as fast as you can. The test measures how much air you are able to push out. This is called forced expiratory volume (FEV). The test results show caregivers how small your airway has become.

  • Exercise test: This checks how long you can walk or do other exercise. It shows how well your lungs work and helps caregivers plan your treatment.

  • Sputum sample: Sputum is collected in a cup when you cough. It is sent to a lab to check for a lung infection.

How is emphysema treated?

The most important thing you can do to treat your emphysema is to stop smoking. The following may help you breathe easier and return to your normal activities:

  • Medicines:

    • Bronchodilators: These help open your airway so you can breathe better. They are most often taken through one of the following devices:

      • Inhaler: This handheld device delivers medicine that you breathe in.

      • Nebulizer: This machine turns liquid medicine into mist that you breathe in through a mouthpiece.

    • Steroids: These help decrease swelling in your lungs. They may be inhaled or taken as a pill.

    • Antibiotics: These are used to kill the bacteria that caused your lung infection.

  • Pulmonary rehabilitation: This program can help you function better with emphysema. You will learn how to manage your symptoms and help keep them from returning. Pulmonary rehabilitation may include walking and other exercises that build up your lung strength.

  • Oxygen: You may need extra oxygen if you have severe emphysema. You breathe the oxygen through a face mask or a nasal cannula. A nasal cannula is a pair of short, thin tubes that rest just inside your nose.

  • Surgery: You may need surgery if you have severe emphysema and all other treatments have failed. A lung reduction is when part of your damaged lung is removed to help you breathe better. A lung transplant is when your lung is replaced with a lung from a donor. Ask your caregiver for more information about emphysema surgery.

What is an exacerbation of emphysema?

An exacerbation is when your symptoms suddenly get worse. You may have a harder time breathing, your cough may get worse, and you may cough up more sputum. You may have a fever, an increased heart rate, or feel sleepy. An exacerbation may be caused by a lung infection, air pollution, or other lung irritants. Sometimes the cause of an exacerbation is unknown. Your caregiver may change your treatment to help relieve exacerbations.

How can I help manage my emphysema and prevent an exacerbation?

  • Do not smoke: If you smoke, it is never too late to quit. Quitting smoking will improve your health and the health of those around you. If you smoke, ask for information about how to stop.

  • Avoid irritants: Wear protective gear if your workplace has dust or chemicals that bother you. Stay inside when air quality is bad.

  • Seek treatment: Get early treatment if your symptoms are getting worse. This may help you recover faster. Know what to do in case of an exacerbation.

  • Exercise: Talk to your caregiver about the best exercise plan for you. Exercise can help decrease breathing problems and improve your health.

  • Use pursed-lip breathing: Pursed-lip breathing can be used any time you feel short of breath. It can be especially helpful before you start an activity.

    • Count to 2 while you take a deep breath in through your nose.

    • Slowly breathe out through your mouth with your lips slightly puckered. You should make a quiet hissing sound as you breathe out.

    • Repeat this exercise 4 or 5 times a day Once you are used to doing pursed-lip breathing, you can use it any time you need more air.
    Breathe in Breathe out

  • Special sleep positions: Sleep with your upper body raised if you have trouble breathing when you lie down. Use foam wedges or elevate the head of your bed. Use a device that will tilt your whole body, or bend your body at the waist. The device should not bend your body at the upper back or neck.

  • To prevent influenza (flu), all adults should get the influenza vaccine every year as soon as it becomes available. The pneumococcal vaccine is given to adults aged 65 or older to prevent pneumococcal disease, such as pneumonia. Adults aged 19 to 64 years who are at high risk for pneumococcal disease also should get the pneumococcal vaccine. It may need to be repeated 5 years later.

What are the risks of emphysema?

  • You are more likely to get lung infections. One or both of your lungs can collapse. You are at greater risk of lung cancer. Severe emphysema can lead to heart disease. Your heart has to work harder because of the damage to your lungs. You may have chest pain or high blood pressure. You can have a heart attack. This can be life-threatening.

  • Lack of oxygen can damage your heart or kidneys. You may develop anemia (not enough red blood cells) or glaucoma (an eye disease). You are at greater risk of osteoporosis (brittle bones) and broken bones.

When should I contact my caregiver?

Contact your caregiver if:

  • You have a fever.

  • You have trouble doing your usual activities because it is hard to breathe.

  • You need to use your inhalers or take breathing treatments more often than usual.

  • You cough up more sputum than is normal for you.

  • You wheeze more than is normal for you.

  • Your legs or ankles are swollen.

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You have pain, pressure, or fullness in your chest that lasts more than a few minutes or returns.

  • You have pain or discomfort in your back, neck, jaw, stomach, or arm.

  • You have shortness of breath that is so severe you cannot talk.

  • Your skin, lips, or nails look blue.

  • You have a sudden cold sweat.

  • You cough up blood.

  • You are confused, dizzy, or feel like you may pass out.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.