Emphysema is a chronic disease makes normal breaking difficult. The disease weakens and breaks down the walls between the tiny air sacs in the lungs. The causes air to collect in larger spaces, instead of many small ones. The air contacts less lung tissue this way, and less oxygen is passed into the bloodstream.

Air travels to the lungs by two major passageways called bronchi. These large airways further divide into tens of thousands of smaller airway routes called bronchioles. At the end of the bronchioles are groups of air sacs, or alveoli. There are about 300 million of these sacs in each lung. These tiny air sacs stretch like balloons when you breathe in, then move oxygen through their thin walls into the blood. The sacs also move carbon dioxide out of the body when you breathe out.

Emphysema patients have weakened air sacs. The thin air sac walls can no longer stretch and contract properly, causing them to break. Air becomes trapped in spaces where sacs have broken, and cannot be released. This makes it harder to breathe.

When you have both emphysema and chronic bronchitis , the condition is called chronic obstructive pulmonary disease (COPD).

See also lung cancer, mediastinal tumors, mesothelioma and sarcoidosis for other diseases that affect the lungs.


The first sign of emphysema is the feeling of not being able to get enough air. In the early stages, shortness of breath (dyspnea) may only be noticeable when you are doing things. In later stages, you may struggle for air even when sitting quietly or lying down.

Other symptoms include:

  • A mild but constant cough
  • Wheezing
  • Continuous production of mucus or phlegm
  • Feeling tired, due to less oxygen getting to the body
  • Poor appetite. Eating becomes more of a strain because it takes more breath.
  • Weight loss, caused by less interest in eating

Causes and Risk Factors

Eighty percent of all emphysema is caused by smoking (including cigarettes, cigars and pipes)..Smoke damages the tiny hairs in the bronchial tubes called cilia, which keep irritating substances and germs out of air passages. When air passages are not regularly cleaned out, they become inflamed and the fibers break down.

Other causes of emphysema are:

  • Air pollution, indoors and outdoors
  • Chemical fumes found in certain workplaces
  • Alpha-1 Antitrypsin Deficiency (AATD), a genetic condition, which results in the lack of a lung-protecting protein.
  • Secondhand smoke

People over 40 years old who have smoked for long periods of their life are at high risk for the condition. People with emphysema are more likely to have other lung diseases, such as bronchitis, pneumonia, asthma and lung cancer.


Diagnosis of emphysema usually begins with a physical exam. Your doctor will ask if you smoke, and for how long. The doctor will also note how severe your symptoms are. The exam will look at your chest and lungs. The doctor will also check your heart for strain from the disease.

After the exam, your doctor will run tests to rule out other conditions, such as cancer, tuberculosis or chronic heart failure, which may cause similar symptoms.

Chest X-rays, computed tomography (CT) scans or a bronchoscopy may be used to rule out tuberculosis or other conditions if a person is coughing up blood. Two-dimensional echocardiography and Doppler techniques may also be used to see if you have high blood pressure in the lungs.

Other tests such as blood oxygen, lung function and exercise testing may be ordered to find out how much damage has been done and how well your lungs are working.


Current treatments for emphysema focus on managing symptoms and making your life better. The cause and severity of your condition help determine which treatment is right for you.

Stopping smoking is the most important change a person with emphysema can make. This can ease some symptoms and put off others. Remove chemicals or other substances that might irritate your lungs from your home and workplace.

Medications may be used to help with symptoms. Corticosteroids may be used to reduce puffiness, or inflammation, in the lungs. Another medicine, called a bronchodilator, may be used to help open the airways. Antibiotics may be used to treat infections that make emphysema worse.

Colds and flu can be especially harmful to people with lung diseases. Keep up with flu and pneumonia vaccinations to lower the risk of getting sick and making your emphysema worse.

Medications may be prescribed to improve airflow and reduce puffiness in the lungs.

Oxygen therapy may be prescribed if the amount of oxygen in the blood is low. This may help with shortness of breath and help you stay active.

For some, surgery may be a treatment option. Lung volume reduction surgery or a lung transplant may be the best option for younger patients with no other medical problems and who aren't responding to medications.