emfyseema

Emphysema, also written emfyseema in some languages, is a lung condition characterized by irreversible enlargement of airspaces distal to the terminal bronchioles, due to destruction of alveolar walls. This leads to a reduced surface area for gas exchange and hyperinflation of the lungs. Emphysema is a major component of chronic obstructive pulmonary disease (COPD).

Most cases arise from long-term exposure to noxious particles or gases, especially cigarette smoke. Other factors include alpha-1 antitrypsin deficiency, occupational inhalants (dust, fumes), and biomass smoke. There are two main anatomical types: centrilobular emphysema, often linked to smoking, and panacinar emphysema, associated with alpha-1 antitrypsin deficiency.

Symptoms typically include progressive shortness of breath, particularly with activity, chronic cough, and sometimes wheeze. Sputum production is less prominent than in chronic bronchitis. On examination, breath sounds may be diminished, expiration may be prolonged, and the chest may be hyperresonant.

Diagnosis is usually based on spirometry, showing a reduced FEV1/FVC ratio, with preserved or increased total lung capacity and residual volume due to hyperinflation. Chest imaging can reveal hyperinflated lungs and destruction of lung parenchyma; testing for alpha-1 antitrypsin deficiency may be performed in selected cases.

Management focuses on symptom control and slowing disease progression: smoking cessation, vaccinations, inhaled bronchodilators (beta-agonists and anticholinergics), inhaled corticosteroids in some patients, pulmonary rehabilitation, and supplemental oxygen for those with hypoxemia. Surgical options, such as bullectomy or, in advanced disease, lung transplantation, may be considered in selected cases.

Prognosis varies with disease severity and comorbidities. Emphysema generally progresses gradually, but appropriate treatment can improve quality of life and exercise tolerance.