What is the Pathophysiology of Emphysema?

J.M. Willhite

The sequential development of signs and symptoms that accompany the presence of emphysema is known as the pathophysiology of emphysema. Considered to be a contributory element of chronic obstructive pulmonary disease (COPD), the pathophysiology of emphysema manifests as the destruction of lung tissue which initially impairs and, ultimately, jeopardizes one’s ability to breathe properly. Frequently diagnosed in current and former smokers, there is no cure for this progressive condition, so treatment is generally centered on symptom management to slow its advancement.

Smoking damages the lungs and puts a person at an increased risk of developing emphysema.
Smoking damages the lungs and puts a person at an increased risk of developing emphysema.

Persistent breathing difficulty generally prompts a visit to a physician to determine the cause of one’s impaired respiration. A variety of laboratory, imaging, and breathing tests are generally administered to confirm a diagnosis of emphysema. Of all diagnostic tests performed, imaging tests, including a computerized tomography (CT) scan and chest X-ray, and pulmonary function tests, which measure one’s lung functionality and volume, are usually the most valuable in that the acquired results may confirm a diagnosis of emphysema in the absence of pronounced symptom manifestation and lung damage.

Unintended weight loss can be a symptom of emphysema.
Unintended weight loss can be a symptom of emphysema.

During the early stages of its development, the pathophysiology of emphysema generally induces pronounced fatigue and shortness of breath with little to no exertion. Individuals may occasionally feel a tightening in their chest or wheeze when they breathe deeply, the presentation of either or both symptoms may adversely impact their ability to complete everyday tasks. As the pathophysiology of emphysema progresses, a symptomatic individual’s physical abilities may become compromised, ultimately limiting his or her activity level.

Emphysema is a form of chronic obstructive pulmonary disease (COPD), which involves enlarged air spaces and destroyed alveoli in the lungs.
Emphysema is a form of chronic obstructive pulmonary disease (COPD), which involves enlarged air spaces and destroyed alveoli in the lungs.

As healthy lung tissue diminishes and blood oxygen levels decrease, symptomatic individuals may develop skin and nail discoloration that presents with a gray hue. With time, the limitations emphysema places on an individual’s physical abilities may lead to a pronounced alteration of one’s physical appearance, as often occurs with unintended weight loss or exhaustion. Additionally, the continued tissue death taking place in the lungs can leave one increasingly susceptible to infection and trigger an expulsion of discolored sputum when coughing.

Wheezing and chest tightness are symptoms of emphysema.
Wheezing and chest tightness are symptoms of emphysema.

Individuals with occupationally induced emphysema, such as those who have worked around hazardous fumes and materials for many years, may possess an increased risk for a more pronounced presentation of the disease. The existence of certain underlying medical conditions may also adversely impact the pathophysiology of emphysema symptoms and promote a more pronounced symptom progression. In addition to one’s age and the contributory nature of certain environmental factors, those who smoke often possess a more accentuated risk for and presentation of emphysemic symptoms.

A chest X-ray can be used to diagnose emphysema in patients.
A chest X-ray can be used to diagnose emphysema in patients.

Considering that a majority of cases of emphysema are diagnosed among smokers, smoking cessation is a fundamental part of any treatment approach to slow the progression of this debilitating condition. Treatment is centered on symptom management, often involving the use of an inhalant medication that may be used to relax airway constriction and ease symptoms. Moderate to severe cases may require the administration of periodic or continuous supplemental oxygen. In situations where traditional treatment approaches do little to ease advanced emphysemic symptoms, individuals must meet established criteria to qualify for lung transplantation candidacy.

Smoking cessation is an important part of any treatment plan.
Smoking cessation is an important part of any treatment plan.

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