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 - Northwestern Memorial Hospital - Chicago


Emphysema is a form of chronic obstructive pulmonary disease (COPD) that occurs when the air sacs in your lungs are gradually destroyed. This progressive lung disease makes you increasingly short of breath over time.

The irreversible damage emphysema causes to the air sacs in your lungs reduces the surface area of the lungs, and, therefore, the amount of oxygen that is able to reach your bloodstream.

This disease also destroys the elastic fibers in your lungs that hold open the small airways that lead to the air sacs—this causes the airways to collapse as you exhale, preventing the air in your lungs from escaping.

Causes of Emphysema

Smoking is the leading cause of emphysema. Any long-term exposure to airborne irritants can cause emphysema, including exposure to:

  • Tobacco smoke
  • Marijuana smoke
  • Coal dust
  • Silica dust
  • Air pollution
  • Manufacturing emissions

Risk Factors for Emphysema

The following increase your risk for developing emphysema:

  • Smoking: all types of smokers are at increased risk for development of emphysema, including pipe and cigar smokers.

  • Age: most people who develop smoking-related emphysema will begin to experience symptoms between the ages of 40 and 60.

  • Secondhand smoke: anyone exposed to secondhand smoke is at risk of getting emphysema.

  • Occupational exposure: chemical fumes and dust from coal, wood, cotton, or grain can increase the risk of emphysema—this risk is even greater if you are a smoker.

  • Exposure to airborne pollutants: fumes from heating oil or car exhaust or smog increases your risk of emphysema.

Signs & Symptoms

The primary symptom of emphysema is shortness of breath, although you can have emphysema for years without any signs or symptoms. Often, people with emphysema will avoid activities that cause them to be short of breath, which may mask their symptoms. Eventually, emphysema will advance to the point where you experience shortness of breath even while at rest.

If you have had shortness of breath for several months, you should see a doctor. If you experience any of the following, you should seek immediate medical attention:

  • You are so short of breath that you cannot speak
  • Your lips or fingernails are turning gray or blue
  • Your heartbeat is very fast
  • Your mental alertness is impaired

Complications of Emphysema

If you have emphysema, you are also more likely to develop the following:

  • Large holes in the lungs (giant bullae): some patients with emphysema develop empty spaces in their lungs, known as bullae, with giant bullae being holes in the lungs as large as half the lung. Bullae reduce the amount of available space for the lung to expand, and can also become infected and increase the risk of pneumothorax.
  • Collapsed lung (pneumothorax): in patients with severe emphysema, the compromise of their lungs can lead to collapse, which can be life-threatening.
  • Heart problems: emphysema can increase the pressure on arteries that connect the heart and lungs, causing cor pulmonale, a condition where the right-hand section of the heart expands and weakens from high blood pressure.

Diagnosis & Testing

Your doctor may perform the following tests to determine if you have emphysema, including:

  • Chest X-ray: this can be used to confirm a diagnosis of emphysema, but cannot make an accurate diagnosis by itself.
  • Computerized tomography (CT) scan: this cross-sectional scan of your lungs may help your doctor get a better view of the lungs, and make a more accurate diagnosis.
  • Blood test: a blood test may reveal how well your lungs are transferring oxygen into your bloodstream, and how efficiently they are removing carbon dioxide.
  • Lung function testing: use of a spirometer, a noninvasive device which measures the inflow and outflow of air from your lungs, may help your doctor diagnose emphysema.


There is no cure for emphysema, however, there are treatments and therapies which doctors may use which can help relieve symptoms of the disease.


Drugs such as Zyban™ and Chantix™ can help you stop smoking, and bronchodilators may be used to help bring relief from coughing and shortness of breath.

Corticosteroids may be inhaled and bring short-term relief from emphysema, although long-term use brings its own side effects, such as weakening of the bones, increase in blood pressure, and diabetes.


Your doctor may recommend a pulmonary rehabilitation program to teach you breathing techniques to help reduce breathlessness and improve your ability to exercise.

If you have severe emphysema, your doctor may recommend that you breathe oxygen from a tank, via a narrow tube that fits into your nose.


In very severe cases of emphysema, there are some surgical options which may also be considered, including the following:

  • Lung volume reduction: surgeons remove small wedges of damaged lung tissue in order to help the remaining lung tissue function more efficiently.
  • Lung transplant: if all other options have failed, if you have severe emphysema, this may be an option.

What You Can Do

While there is no cure for emphysema, there are steps you can take to halt its progression.

  • Stop smoking: the most important thing you can do for your overall health and which may halt the progression of emphysema.
  • Avoid secondhand smoke: this can also help you keep emphysema from getting worse.
  • Avoid respiratory irritants: changing furnace filters and air conditioner filters can help reduce airborne pollutants; avoiding paint and automobile exhaust fumes and other airborne irritants can help.
  • Exercise: regular exercise can help increase your lung capacity.
  • Beware of cold air: cold air can cause bronchial spasms, which may make it difficult to breathe. During cold weather, you should wear a scarf or a cold-air mask over your mouth and nose to warm the air entering your lungs. A cold-air mask can be found at a pharmacy.
  • Avoid respiratory infections: annual influenza immunization and getting a pneumonia vaccination can help you protect your lungs from infection. Taking careful steps to avoid getting colds or the flu can help.
  • Wear a mask while working: if you work with chemical fumes or dust, consider wearing a filtration mask to protect your lungs.

Seeking Support

You may want to join an emphysema support group. You can contact the American Lung Association or ask your doctor if there is an emphysema support group in your area.

Last UpdateFebruary 14, 2012


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