Pulmonary Emphysema
What is pulmonary emphysema? Information about its causes, symptoms, and the most innovative treatments.
Symptoms and Causes
Pulmonary emphysema is a chronic disease that makes breathing difficult due to the deterioration of the alveoli. As a result, lung capacity is affected, reducing the amount of oxygen that reaches the organs through the bloodstream. Over time, the tissue that keeps the airways open is destroyed, causing them to gradually close and increasing the amount of trapped air inside the lungs. This makes it harder to expel carbon dioxide.
There are different types of emphysema based on its location in the lungs:
• Centrilobular or centrilobular emphysema: Primarily affects the upper part of the lobes.
• Paraseptal emphysema: Damages the peripheral part of the lobule, near the pleura.
• Panlobular or panacinar emphysema: Affects the entire lobule and gradually spreads throughout the lung.
• Irregular emphysema: Spreads unevenly through the acinus, the unit where gas exchange occurs, and is often associated with scarring processes.
Many people mistakenly believe that emphysema is cancer, but it is not. However, having this disease increases the risk of developing a malignant lung tumor. Additionally, it contributes to conditions such as bronchitis and chronic obstructive pulmonary disease (COPD), making patients more likely to have multiple conditions.
When pulmonary emphysema is mild, life expectancy is almost the same as that of healthy individuals, provided that certain lifestyle changes are made. In more severe cases, life expectancy is typically around 20 years from diagnosis.
Symptoms
The symptoms of pulmonary emphysema, which may take years to appear, mainly include:
• Shortness of breath.
• Excessive fatigue during exercise.
• Cyanosis (bluish discoloration of the skin and nails) when exerting effort.
Causes
Depending on the underlying causes, pulmonary emphysema is classified into two types:
• Hereditary emphysema: Rare. It occurs due to a deficiency of the alpha-1 antitrypsin protein, which protects lung structures.
• Acquired emphysema: The most common type. It is caused by smoking or prolonged exposure to smoke, dust, chemical vapors, or pollution.
Risk Factors
In some cases, genetic factors play a role, although this is not common. Generally, the risk of developing pulmonary emphysema is higher in the following situations:
• Smoking (active or passive).
• Age between 40 and 60 years.
• Continuous exposure to chemical gases or polluted environments.
Complications
People with pulmonary emphysema may develop heart problems, have bullae (large air-filled spaces) in the lungs that reduce lung capacity, or suffer from pneumothorax.
Prevention
Pulmonary emphysema can be prevented by avoiding the inhalation of pollutants, particularly by not smoking.
Which Doctor Treats Pulmonary Emphysema?
Pulmonologists diagnose and treat pulmonary emphysema. Additionally, it is recommended to visit a smoking cessation unit for guidance and support.
Diagnosis
During the consultation, the specialist listens to the patient's symptoms and reviews their medical history. Additionally, the following diagnostic tests are performed:
- Physical examination.
- Chest X-ray: Identifies lung changes and helps rule out other diseases with similar symptoms.
- Computed tomography (CT) scan of the lungs: Detects alterations at earlier stages and assesses the extent of emphysema.
- Pulmonary function tests, such as spirometry: Measures the amount of air expelled during an exhalation.
- Arterial blood gas test: Determines the levels of oxygen and carbon dioxide in the blood.
Treatment
Pulmonary emphysema has no cure, so treatments focus on slowing its progression, improving patients' quality of life, and alleviating symptoms. The most notable treatments include:
- Medications to relieve cough, reduce inflammation (bronchodilators), improve breathing (inhaled corticosteroids), or treat infections (antibiotics).
- Rehabilitation to enhance lung capacity.
- Oxygen therapy to increase oxygen levels in the blood. Depending on the severity of the disease, it may be needed only after exercise or more regularly.
- Surgery to remove the most damaged parts of the lung lobe.
- Lung transplant in cases of severe damage.
