Signs and Symptoms
Emphysema is a disease of the lung tissue caused by destruction of structures feeding the alveoli, in some cases owing to the consequences of alpha 1-antitrypsin deficiency. Smoking is one major cause of this destruction, which results in the collapse of small airways in the lungs during forced exhalation. As a result, airflow is impeded and air becomes trapped, just as in other obstructive lung diseases. Symptoms include shortness of breath ("dyspnea") on exertion and an expanded chest.
People with this disease do not get enough oxygen and suffer a buildup of carbon dioxide in their blood, which generates dyspnea. At first, when emphysema is mild, dyspnea occurs only during physical activity. Eventually, as the disease progresses, dyspnea will occur after even small amounts of physical exertion. On the other hand, if the lungs are compromised badly enough, the victim may feel short of breath all the time - even when at rest, relaxing. Because breathing is more difficult, the person must use accessory muscles to help them breathe; the increased work of breathing, use of additional muscles, and blood gas abnormalities then combine to cause "tachypnea" (rapid breathing), which may continue in a "vicious cycle". Individuals with severe emphysema eventually may have trouble coughing and decreased amounts of sputum. They may also lose weight.
The anteroposterior diameter of their chest may increase; this sign is sometimes referred as "barrel chest." Patients may lean forward with arms extended and/or resting on something to help them breathe ("orthopneic breathing").
When lung auscultation and chest percussion is performed a hyperresonant sound is heard.
The patient may also exhibit symptoms of hypoxia-induced cyanosis, or the appearance of a blue-to-purplish discoloration of the skin, due to increased levels of deoxyhemoglobin in the blood.
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