What is COPD?

Chronic Obstructive Pulmonary Disease (COPD) is a disease that affects the lungs by blocking the airflow and making it hard to breathe. Two common types of COPD are chronic bronchitis and emphysema, and most people with COPD have a combination of both types of the disease.


What is Emphysema?

Emphysema is a form of Chronic Obstructive Pulmonary Disease - COPD.1

Emphysema is called a Chronic Obstructive Pulmonary Disease (COPD) because the tissue that normally holds the lung airways open gets destroyed. Emphysema is characterized by an abnormal and permanent destruction and enlargement of tiny air spaces called “alveoli” that transfer oxygen from the lungs to the bloodstream. The alveoli in the lungs are clustered like bunches of grapes. In emphysema, the inner walls of the alveoli weaken and break, creating one larger air space instead of many small ones. This reduces the ability of the lungs to take in oxygen and remove carbon dioxide.

It is difficult for patients with emphysema to breathe because their airways collapse when they try to exhale, trapping the old air in their lungs and leaving little room for fresh, oxygen-rich air to enter. This “air trapping”, combined with the damaged alveoli and less oxygen transfer to the blood, results in a feeling of breathlessness. Emphysema is a “progressive” disease, that is, as lung damage continues over time this feeling of breathlessness also increases.

In the early stages of emphysema, patients may notice shortness of breath (dyspnoea) only when they exercise. As their emphysema gets worse, they may become short of breath when performing everyday activities (such as bathing or dressing) or even when they are at rest (rest dyspnoea). Patients with emphysema feel generally exhausted and their exercise capacity is reduced. There may also be a bluish tinge to the lips and the tips of fingers and toes (cyanosis) because of the reduced oxygen content of the blood.

Those who have advanced emphysema feel physically restricted, even in everyday tasks. The smallest exertion, such as climbing stairs or going to the supermarket, can become a problem.

1Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive     Pulmonary Disease. Accessed Nov 22, 2016

What Causes Emphysema?

There are many causes of emphysema. The major factors for developing severe emphysema include:

  • Smoking cigarettes
  • Exposure to second hand cigarette smoke
  • Occupational hazards such as exposure to chemical fumes, smoke, or dust
  • Long term exposure to other lung irritants such as air pollution

Little is known about why some patients develop emphysema and other patients do not. In some patients, emphysema may be related to genetics or may result from the body not producing enough of a specific protein to protect the lungs and liver (alpha-1-antitrypsin deficiency). Genetics may also cause some people’s emphysema to get worse faster than in other people.


What are the Signs and Symptoms of Emphysema?

The signs of emphysema are what physicians look for in a patient to help identify emphysema and its severity. The onset of emphysema is typically slow and gradual over time. Signs of emphysema include:

  • Breathlessness
  • Decreasing Exercise Capacity
  • Gradual expansion of the chest (also known as “barrel chest”)
  • Clubbing or rounding of the fingertips
  • Underweight, malnutrition
  • Bluish lips due to decreased levels of circulating oxygen in the bloodstream

In smokers who develop emphysema, the first symptoms usually begin between the ages of 45 and 60. Everyone suffering from emphysema will experience shortness of breath, especially with physical exertion, such as exercise. The feeling of breathlessness can get worse if the patient continues to smoke cigarettes. Many people with emphysema may develop other common symptoms such as:

  • Wheezing
  • Coughing

People with emphysema may also develop some other less common symptoms such as:

  • Loss of appetite and weight loss
  • Depression
  • Poor sleep quality
  • Anxiety in situations of extreme breathlessness