Emphysema In this disorder, the tiny air sacs in the lungs, called alveoli, are destroyed. The lungs are unable to contract fully and gradually lose elasticity. Holes develop in the lung tissue, reducing the lungs' ability to exchange oxygen for carbon dioxide. As a result, breathing may become labored and inefficient, and you may feel breathless most of the time.
You are more likely to develop emphysema if you:
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Smoke
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Are exposed to passive ("secondhand") smoke
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Are exposed to airborne irritants or noxious chemicals (lead, mercury, coal dust, hydrogen sulfide)
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Live in an area with significant air pollution (high levels of sulfur dioxide and particulates)
An estimated 100,000 people in the United States have an inherited form of emphysema in which the lungs lack a protective protein called alpha-1-antitrypsin. In people with this form of the disease, lung damage can appear as early as age 30, decades sooner than smoking-related emphysema usually starts.
Symptoms
People with COPD commonly have symptoms of both chronic bronchitis and emphysema.
Chronic Bronchitis Your first symptom may be a morning cough that brings up mucus and that occurs at first only during the winter months. As the illness progresses, the cough begins to last throughout the day and throughout the year, and produces more mucus. Eventually, about 15% of people with chronic bronchitis develop a continuous cough, breathlessness, rapid breathing, or a bluish tint to the skin from lack of oxygen.
Chronic bronchitis also makes you prone to frequent respiratory infections and to potentially life-threatening flare-ups of severe breathing difficulties that often require hospitalization. If heart failure develops, there may be swelling in the ankles, legs, and sometimes the abdomen.
Emphysema If you have emphysema, you may first feel short of breath during activities such as walking or vacuuming. Because lung function decreases slowly in emphysema, you may hardly notice as breathing becomes more and more difficult. With time, you may develop increased shortness of breath, wheezing, coughing, a tight feeling in the chest, a barrel-like distended chest, constant fatigue, difficulty sleeping, and weight loss.
