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Emphysema
The American Lung Association estimates that nearly 3 million
Americans are diagnosed with emphysema annually. The condition is
degenerative and usually develops slowly over time. It occurs when
the lung’s tiny, balloon-like air sacs (alveoli) become over-stretched
or destroyed and fail to allow enough oxygen to get into the bloodstream.
The lungs expand well, but do not contract so the air does not exit
the lungs well. Less oxygen travels to the bloodstream and shortness
of breath and labored breathing become more apparent.
Cause: Smoking is by far the primary cause of emphysema.
Other contributing factors include air pollution, exposure to certain
home and workplace fuels, chemical fumes, secondhand smoke and dust
from cotton, wood and mining substances, and a rare genetic disorder.
Symptoms: Shortness of breath, whether during strenuous activity,
moderate activity or even at rest, predominates as the most obvious
signal of the disease. Constant mucus production, coughing up colored
sputum and wheezing are other symptoms.
Diagnosis: In addition to observing how hard it is for the
person to breathe, the physician will conduct a careful examination
which includes listening to the lungs and heart. Other diagnostic
procedures are:
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Arterial blood gas test to analyze carbon dioxide
and oxygen levels |
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X-rays, especially in moderate to late-stage
disease |
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Pulmonary function tests (PFTs), including
spirometry to measure air production during deep-breath inhaling
and exhaling |
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Pulse oximetry, to determine how well oxygen
is being sent to the blood and how effectively oxygen is being
removed. |
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Sputum analysis |
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CT scan, to “view” the lungs |
Treatment: Emphysema is not curable but methods are available
to stop further damage, slow the progress of the condition and ease
discomfort. They include use of antibiotics, bronchodilators, anti-inflammatory
drugs and supplemental oxygen.
For serious cases, a surgical procedure called lung volume reduction
surgery (LVRS) involves removing the most severely affected areas
of the lungs. This allows the remaining lung tissue to work more
effectively. That reduces the sense of shortness of breath, improves
exercise tolerance, improves quality of life, and improves survival.
Lung transplantation is another surgical option for select patients.
This is a procedure which involves replacing the damaged lung with
a donor lung. The normal response of a body when an organ is transplanted
from another person is to attack the new body part. Many medicines
are used to reduce this rejection. That requires close follow up.
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