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Emphysema

What is it?

The term "emphysema" marked pathological processes in the lung, characterized by a high content of air in the lung tissue, a chronic lung disease characterized by respiratory failure and pulmonary gas exchange. Disease name comes from the Greek. emphysao "inject", "blow up".

In recent years, increasing the frequency of emphysema, especially among the elderly.
A significant prevalence of the disease, a progressive course, temporary disability and early development of the disability of patients with respiratory failure due to pulmonary heart disease and cause significant economic damage. Emphysema, along with chronic obstructive bronchitis and bronchial asthma refers to a group of chronic obstructive pulmonary disease (COPD). All these diseases are accompanied by bronchial obstruction, which accounts for the similarity of some of their clinical picture. However, each of the forms of COPD has its own specific characteristics, and correct and timely diagnosis of these diseases allows for targeted prevention and rational treatment.

The causes of pulmonary emphysema

The main cause of the disease - chronic bronchitis, which is meant by a chronic infection. Chronic bronchitis usually develops between the ages of 30 to 60 years and occurs more often in men than in women. In fact, the result is the formation of chronic bronchitis emphysema.

In the development of bullous emphysema an important role is played by hereditary factors, as well as deferred lung diseases (tuberculosis, etc.).

Smoking, air pollution by different dust particles and some conditions, such as those associated with continuous inhalation of coal dust or asbestos particles and silicon, also contribute to the development of the disease.

At the same time, emphysema, leading to severe respiratory failure, may develop without a preceding respiratory disease, that is, be the primary.

What happens in the lungs?

The development of emphysema is associated with irreversible changes in the wall of the bronchus and lung inflammation under the influence of long-term, long-term narrowing of the airways. Violated elastic properties of light: they began to stay after exhalation more air than it should be the norm, resulting in hyperextension (swelling) of the lungs. This excess air is not involved in breathing and lung tissue hyperinflate not working fully. That, in turn, is accompanied by loss of ability to a sufficient reduction in exhalation and difficult, resulting in impaired oxygen delivery to the blood and removing carbon dioxide from it. Compensatory, to improve the removal of carbon dioxide, there is shortness of breath.

Also in the bronchi and the lungs begins to progressively increase the amount of connective tissue, which, as it "replaces" air sections of lung tissue, and promotes long-term narrowing of the bronchial tubes is independent of the existing inflammation.

Because of these changes in the lungs produced numerous air bags of various sizes that can be scattered throughout the lung (diffuse form of emphysema). Sometimes the swollen parts of the lungs combined with normal lung tissue (the local form of emphysema). Also separately isolated bullous emphysema (bulla is emphysematous (swollen) area larger than 1 cm).

Symptoms of emphysema

By "classic" manifestations of diffuse pulmonary emphysema include:

- Severe shortness of breath;
- Cyanosis;
- Increase (rounded) of the chest and a decrease of respiratory movements;
- Expansion and sometimes bulging of intercostal spaces;
- Expansion or bulging supraclavicular regions.

In the early stages of emphysema is the main symptom of exertional dyspnea. At first, she is fickle and often manifests itself in the winter, then at any time of year. In the future, shortness of breath occurs at the slightest exertion, and, finally, there may be at rest. Patients are observed a short, "acute," "enough" breath and long exhale. They carry out breath with dense lips, puffing out his cheeks ("puff"). Respiratory movements of the chest reduced in breathing muscles are more involved: the chest and neck.

Shortness of breath, that for many years, appearing noticeably and gradually progresses, it becomes a condition that threatens the life of the patient.

Patients with emphysema in the initial stages of the disease take a forced situation on his stomach with his head bowed down and the shoulder belt that brings them relief. However, in severe emphysema with marked changes in the chest and fatigue of respiratory muscles causes a horizontal position the hard work of the diaphragm, so patients are forced to even sleep in a sitting position. Patients with emphysema are often occupied by a sitting position with slightly bent forward his body, resting his hands on his knees and the edge of the bed, which allows to fix the shoulder girdle, and include additional muscles in the act of breathing.

In advanced cases there is cyanosis: the language appears a blue tint, the lips and fingernails are bluish, especially after physical exertion.

Complications

- Respiratory failure;
- Heart failur;
- Pneumothorax (air injection in the chest).

Any of the complications leading to disability.

What can you do?

Treatment should begin at the stage of bronchitis, before the development of emphysema. Because more often because of late presentation to the patient to the doctor at the time of first contact in the lung is usually irreversible changes have already occurred, which greatly complicates the subsequent treatment.

It is essential that a sick person was directly involved in treatment. He should understand and realize the seriousness of the disease and possible complications.

Required categorical exclusion of smoking and other harmful, including professional effects on lung tissue, limiting physical activity, good jobs.

Quitting smoking is an extremely important event. It should take first place in the treatment of this pathology. It should be borne in mind: cross-sectional smoking cessation has a greater effect than a gradual decrease in the number of cigarettes smoked, high motivation to quit is a major determinant of success, chewing gum and cutaneous applicators that contain nicotine and help reduce the craving to smoke, especially if they are applied in a complex of measures aimed at smoking cessation.

What can your doctor?

Your doctor (pulmonologist or internist) will conduct the necessary survey:

- Inspection, auscultation (listening), percussion (tapping) of the chest;
- X-ray examination of the lungs (characterized by inflation of the lung tissue and increase of its lightness, the displacement of the diaphragm down);
- CT scans of the lungs, most often used for the diagnosis and determining the exact location of bullae;
- Study of respiratory function: allows you to identify the degree of impairment of lung function (to reduce the amount of air that is able to breathe a patient).

The main treatments for emphysema:

- Smoking cessation: as already mentioned, the main method of prevention and treatment of emphysema;
- Oxygen therapy (inhalation of air with high oxygen content, and possibly at home);
- A special breathing exercises;
- Adequate and thorough treatment of the disease, leading to emphysema (chronic bronchitis, bronchial asthma) in infectious processes and their prevention should be used with antibiotics. Also, using drugs that reduce the amount of phlegm and thinning it, making it easier to cough up, and injected substances that extend the relieving spasm of the bronchi and the bronchial muscles.

At bullous emphysema recommend surgical treatment. The essence of treatment removal of bulls. Such operations can be executed by the classical access with the opening of the chest, and endoscopy (using special tools, a puncture of the chest). Timely removal prevents the development of such a bull threatening complications such as pneumothorax.

In any case it is impossible to self-medicate. If you suspect yourself or have your family member emphysema, you should immediately consult a specialist for diagnosis and timely initiation of treatment. In the case of severe forms of the disease your doctor may suggest processing of disability. But to ensure that the disease has not led to complications and disability the patient must be treated to a specialist and he has observed in case you get sick with chronic bronchitis, have bad habits, or occupational hazards associated with inhalation of coal dust or particles of asbestos and silica.