Emphysema

What is emphysema?

Emphysema is a disease that damages the tiny air sacs (alveoli) in the lungs, making it hard to breathe. Normally, the alveoli expand as you inhale and shrink to push air out when you exhale. With pulmonary emphysema, the lungs lose their elasticity, trapping air inside and making it difficult to take in fresh oxygen. Along with chronic bronchitis, emphysema is a common form of chronic obstructive pulmonary disease (COPD), a group of lung conditions that gradually reduce lung function.

Pulmonologists diagnose and treat respiratory diseases like emphysema and COPD. At Penn Medicine, our pulmonary specialists provide comprehensive care, bringing together radiologists, chest surgeons, lung doctors, advanced practice nurses, and respiratory therapists—all in one convenient location.

Types of emphysema

There are three main types of emphysema:

Centrilobular emphysema: The most common type, it usually begins in the respiratory bronchioles of the upper lungs and is often linked to long-term cigarette smoking.

Paraseptal emphysema: This type typically affects the outer areas of the lungs, like the septa or pleura, and is often associated with past lung infections or inflammation.

Panacinar emphysema: Usually found in the lower lungs, this type is linked to a genetic condition called alpha-1 antitrypsin deficiency.

Emphysema symptoms

The first signs of emphysema are mild and develop slowly, so you may not notice any changes until lung damage has already occurred. The most common symptoms are shortness of breath and fatigue. Other symptoms include:

Coughing
Wheezing
Chest tightness
Weight loss
Barrel chest (caused by trapped air in the lungs)
Ankle swelling
Increased mucus (which can block airways)

What causes emphysema?

Emphysema develops when the lungs are damaged by harmful substances or certain health conditions.

Smoking and other pollutants

Respiratory infections

Diagnosing emphysema

To diagnose emphysema, your provider may order tests that measure your oxygen and carbon dioxide levels and how much air you can breathe in and out. If you have a family history of lung disease, genetic testing may be done for alpha-1 antitrypsin deficiency. Imaging tests can also help detect lung damage and rule out other conditions.

Echocardiogram

An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a standard x-ray image. An echocardiogram does not expose you to radiation. x-ray

X-ray

We use x-rays to diagnose broken bones, lung problems, and many other conditions.

CT scan

A CT scan helps diagnose traumatic injuries, cancer, vascular diseases, and many other conditions.

Pulmonary function tests

These tests look at various aspects of your lung function to help diagnose and treat pulmonary disease.

Emphysema treatment

While there’s no cure for emphysema, treatment can help manage symptoms and improve your quality of life. Your provider may prescribe medications to relax the airways and help reduce inflammation in your lungs.

Pulmonary rehabilitation, which includes breathing exercises, education, and fitness training, can also be beneficial. Lifestyle changes, such as quitting smoking, avoiding lung irritants, and staying active, can slow the disease’s progression. In severe cases, surgery may be an option.

Lung transplant surgery

Lung transplant surgery is a lifesaving procedure for end-stage lung disease.

Lung volume reduction surgery

When emphysema causes severe lung damage, removing the most damaged tissue can help improve your breathing.

BiPAP therapy

This therapy helps people breathe more effectively without the need for surgery or a breathing tube.

Can emphysema be prevented?

The best way to lower your risk of emphysema is to avoid smoking or quit if you already smoke. Staying away from secondhand smoke and other lung irritants also helps protect your lungs.

Get annual flu shots and a pneumonia vaccine, and take steps to avoid colds or the flu. If you have a genetic risk, regular checkups and early treatment may help prevent severe lung damage.

Comprehensive care for emphysema

Penn Medicine’s lung specialists diagnose and manage complex breathing conditions, offering advanced testing and therapies for emphysema to help you breathe easier. The Harron Lung Center provides more leading-edge care options than any other lung program in the southeastern Pennsylvania and New Jersey regions.

For those looking to quit smoking, our smoking cessation programs offer dedicated support groups and resources to improve your quality of life while living with emphysema. If advanced intervention is needed, the Penn Transplant Institute is a leader in organ transplantation, performing the most transplants in the greater Philadelphia, Lancaster, and Princeton regions and ranking among the nation’s top 10 multi-organ transplant centers.