Pulmonary Emphysema

emphysema

 or pulmonary emphysema

Abnormal distension of the lungs with air, usually associated with cigarette smoking and chronic bronchitis. Elastic tissue degenerates, severely interfering with exhalation. Capillary walls disappear, leaving lung tissue dry and pale. The walls of the pulmonary alveoli (see pulmonary alveolus) break down, so the lung fills with pools of air. Symptoms include severe breathlessness, weight loss, bluish skin, chest tightness, and wheezing. In bullous emphysema, the alveoli form large air cysts that may rupture, causing lung collapse (see atelectasis), or require surgery. Emphysema is irreversible; it normally continues to progress even after the cessation of smoking and may lead to death. See also pulmonary heart disease.

---

Emphysema, Pulmonary 

the name for various pathological conditions characterized by an excessive amount of air in the lungs.

Pulmonary emphysema may be congenital or acquired, localized or diffuse, and acute or chronic. In humans, it is caused by a deficiency of the enzyme α₁-antitrypsin. Acute acquired emphysema is caused by acute bronchial obstruction, as in bronchial asthma. Chronic diffuse emphysema often develops as a complication of chronic bronchitis, bronchial asthma, pulmonary fibrosis, pneumoconiosis, and other diseases of the bronchopulmonary system as a result of bronchial obstruction. Exhaling requires increased pressure within the alveoli, which leads to compression of small bronchi, entry of air into collapsed alveoli through the interstitial pores, and merging of the alveoli.

The disease also decreases the elasticity of pulmonary tissue. The volume of the lungs increases, the alveolar septa become attenuated, and the capillaries break down. Patients suffer from a cough, sometimes with sputum, as well as shortness of breath and difficulty in exhaling. The chest is barrel-shaped, and the intercostal spaces are flattened. Characteristic body changes are revealed by percussion and auscultation of the lungs, X-ray examinations, electrocardiograms, and the determination of the lung capacity and other parameters of external respiratory function. Progressive emphysema gives rise to cor pulmonale and pulmonary and cardiac insufficiency.

Treatment depends on the main process in the lungs. It includes the use of antispasmodics, expectorants, oxygen therapy, antibiotics, sulfanilamides, and corrective exercise. Prevention requires the prompt treatment of chronic respiratory diseases, especially chronic bronchitis.

REFERENCES

Mukharliamov, N. M. Legochnoe serdtse. Moscow, 1973.
Malova, M. N. Emfizema legkikh. Moscow, 1975.

N. M. MUKHARLIAMOV

Acute pulmonary emphysema also occurs in animals, for example, horses, oxen, and draft dogs after strenuous work. It also occurs as a result of constriction of the lumen of the respiratory pathways or bronchi, or extensive inflammation of the lungs. Treatment includes the administration of sedatives, expectorants, and disinfectants. Chronic pulmonary emphysema develops from acute pulmonary emphysema or some disease associated with severe coughing. It is incurable.