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Emphysema: Lungs
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Emphysema is most common among people age 50 and older. It is the most common cause of death from respiratory disease in the United States, and usually occurs in heavy cigarette smokers. However, pipe, cigar, and marijuana smoking can ... damage the lungs. Some people have an inherited condition called Òearly onset emphysemaÓ because it can appear as early as 30 to 40 years of age. This type of emphysema is caused by low levels of an enzyme inhibitor called alpha-1-antitrypsin (AAT). Approximately 75,000 to 150,000 Americans have an AAT-deficiency, but not all develop emphysema.
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Emphysema is a disease that causes the alveoli (the tiny air sacs where the air meets the blood in your lungs) not to work properly. This means not as much oxygen can get into the blood of the person, and it makes breathing difficult. Because the blood isn't getting as much oxygen as it is supposed to, the body cells aren't getting the oxygen they need to release the energy in food. A person with emphysema can't exercise, because the lungs aren't able to supply enough oxygen. A person with severe emphysema can't even go for a walk without running out of breath!
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Emphysema results when the lungs are over inflated due to destructive changes to the alveolar walls, usually as a result of smoking. The lungs become rigid and are not able to absorb much oxygen, so emphysema patients will often be seen with a tube up their nose and a bottle of oxygen by their side. Whereas asthma sufferers have difficulty getting air into their lungs, emphysema sufferers feel like they have difficulty getting air out of their lungs. Due to labored breathing and lung rigidity, they tend to develop a characteristic "barrel chest" appearance, where the front to back measurement of the chest approximates the side to side measurement. The damage that occurs to the lungs in emphysema is generally irreversible, even with the cessation of smoking.
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Emphysema occurs in a higher proportion in patients with decreased alpha 1-antitrypsin (A1AT) levels (alpha 1-antitrypsin deficiency, A1AD). In A1AD, inflammatory enzymes (such as elastase) are able to destroy the alveolar tissue (the elastin fibre, for example). Most A1AD patients do not develop clinically significant emphysema, but smoking and severely decreased A1AT levels (10-15%) can cause emphysema at a young age. The pattern of emphysema in A1AD is described as panacinar (involving the entire acinus) as opposed to the centrilobular pattern seen with smoking; the former typically affects the lower lungs, and the latter affects the upper lungs. In all, A1AD causes about 2% of all emphysema. However, smokers with A1AD are in the highest risk category for emphysema.
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Emphysema is defined as a destruction of alveolar walls and consequent enlargement of air spaces. The main known cause is cigarette smoke, but a few cases are caused by an inherited lack of the enzyme alpha-1-antitrypsin. Emphysema may involve different parts of the lung for reasons that are not clear. In the severe forms, all are associated with difficulty breathing (shortness of breath). The expiratory phase of breathing is prolonged and may be accompanied by audible wheeze.
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Emphysema is characterized by a progressive deterioration in lung tissue leading to the constant feeling of breathlessness and inability to engage in a broad range of normal daily activities. Unable to breathe properly, emphysema patients gradually reduce their physical activity in an attempt to regulate the symptoms of the disease. This leads to a progressive decline of their cardiovascular system and muscle mass. As the disease advances, the patients may become unable to perform simple daily functions. Basic tasks such as climbing a flight of stairs, shopping for groceries or even eating, can be challenging for someone with emphysema.
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