Emphysema

Emphysema Lung Is the permanent widening of the structure of pulmonary gas exchange that is distal to the terminal bronchioles, accompanied by destruction of alveolar walls.

Etiology
  1. Main factors: smokers either active smoking or passive smoking depending on the length, number, how to smoke.
  2. Air pollution, in the form: Particles, These chemicals, Toxic Gas
  3. Infections: viral and bacterial
  4. Genetics:
a. Talent arise emphysema
b. The balance of destructive enzymes (protease) & protective enzymes (alpha-1-antitrypsin).

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Pathogenesis
Inhalation of cigarette smoke or pollutants stimulate cells in the lung macrophages and neutrophils produce elastase and collagenase is an enzyme that damages the fibers of elastin and collagen, and which is the framework of the alveoli and acini in order not to collapse. Smoking also inhibit the action of alpha-1-antitrypsin, an enzyme that protects elastin fibers against proteases.
In the lung there is a balance between destroying enzyme (protease) and protective enzymes (alpha-1-antitrypsin). Due to destruction of fibers of the lung elastin & collagen loss of elastic recoil.

Complaints and Clinical Symtomps
Progressive shortness of breath, tired easily when moving.
Pure emphysema without coughing, shortness, of breath sounds, sputum.
Breathing by means of "purse lips" aims to breathe more easily because of the onset of back pressure in the bronchioles so easy expiration and prevent "water trapping".

On physical examination found:
Chest barrel shaped chest, the space between the ribs widen.
Lung hyperinflation, the percussion sounds hipersonor, reduced chest expansion, difficulties inspiration, decreased breath sounds, rhonchi could be heard when there is phlegm.

Diagnosis
Based on anamnesa, complaints and symptoms, supplemented by investigation as follows:
  • PA chest X-ray photo:
Lung looks hyperaereted.
Reduced vascular picture and not look at the third peripheral lung field, it appears the bulla, where the diaphragm is low, little heart shape in the form of water droplets.
  • Tests pulmonary physiology:
Showed abnormalities obstruction.
FEV1 <80% pred. and restrictive decreased FVC <70%, RV> pred. in accordance with lung hyperinflasi
  • Examination of enzymatic:
Levels of alpha-1-antitrypsin is low.
  • Analysis of blood gases:

There hipercapnea hypoxemia and the alveoli as a result of capillary damage and interference ratio of ventilation / perfusion.

Differential Diagnosis

Management of Emphysema
  • Prevention: stop smoking, reduce exposure to air pollution.
  • There is no effective treatment and satisfactory.
  • Treatment with a new bronchodilator reversibility is given when there is obstruction.
  • Antibiotics are given if there are signs of respiratory tract infection.
  • Oxygen increases when crowded.
  • Rehabilitation of relaxation with breathing exercises, postural drainage, exercise improves breathing capacity.
  • Treatment of the complications.

Complications
  • Pneumothorax: outbreak caused superficial bulla
  • Respiratory failure: due to bad ratio of ventilation / perfusion
  • Cor pulmonale: arise due to pulmonary hypertension due to hypoxemia and pulmonary vasospasm
  • Weight loss until emasiasi.

Prognosis
In emphysema caused by deficiency of alpha-1-antitrypsin bad prognosis.
Prognosis is determined by:
  • The rate of progression of the emphysema
  • The degree of bronchial obstruction and reversibilitasnya
  • The presence of complications
  • The accuracy of the management of emphysema.
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10 comments:

  1. Generally we do not have any type of information and we do not know about some disease but now a days there are lots of information provide on internet. I read this your details about Emphysema disease and i am aware about this disease. Hope all are know about Emphysema.

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  3. I had COPD for 9 years. My first symptoms were dry cough, chest tightness and shortness of breath. My first chest x-ray only showed bronchitis. Finally I went to a pulmonologist and was diagnosed with COPD.i have used all the medication yet they don’t work, last year December I was told by a formal emphysema patient to use totalcureherbsfoundation. c om herbal treatment which I really did,i was surprise the herbal products effectively get rid of my COPD totally. When you get where you cannot breathe it may be too late. Good luck to each and every one that will be trying their herbal treatment .

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  4. I had COPD for 9 years. My first symptoms were dry cough, chest tightness and shortness of breath. My first chest x-ray only showed bronchitis. Finally I went to a pulmonologist and was diagnosed with COPD.i have used all the medication yet they don’t work, last year December I was told by a formal emphysema patient to use  totalcureherbsfoundation. c om herbal treatment which I really did,i was surprise the herbal products effectively get rid of my COPD totally. When you get where you cannot breathe it may be too late. Good luck to each and every one that will be trying their herbal treatment .

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  5. I am not sure of the cause of COPD emphysema in my case. I smoked pack a day for 12 or 13 years, but quit 40 years ago. I have been an outdoor person all my adult life. Coughing started last summer producing thick mucus, greenish tint to clear. I tried prednisone and antibiotics, but no change. X-rays are negative, heart lungs and blood and serum chemistries all are normal. I have lung calcification from childhood bout with histoplasmosis. I am 75 years old and retired.My current doctor directed me to totalcureherbsfoundation .c om which I purchase the COPD herbal remedies from them ,they are located in Johannesburg, the herbal treatment has effectively reduce all my symptoms totally, am waiting to complete the 15 weeks usage because they guaranteed me total cure.

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  6. I'm 59 years old and female. I was diagnosed a couple of years ago with COPD and I was beyond scared! My lung function test indicated 49% capacity. After having had flu a year ago, the shortness of breath, coughing and chest pains continued even after being treated with antibiotics. I've been smoking two packs a day for 36 years. Being born without a sternum caused my ribs to be curled in just one inch away from my spine, resulting to underdeveloped lungs. At age 34 I had surgery and it was fixed. Unfortunately my smoking just caused more damage to my already under developed lungs. The problem was having is that I enjoy smoking and don't want to give up! Have tried twice before and nearly went crazy and don't want to go through that again. I saw the fear in my husband and children's eyes when I told them about my condition then they start to find solution on their own to help my condition.I am an 59 now who was diagnose COPD emphysema which I know was from my years of smoking. I started smoking in school when smoking was socially acceptable. I remember when smoking was permitted in hospitals. It was not known then how dangerous cigarettes were for us, and it seemed everybody smoked but i was able to get rid of my COPD lung condition through the help of total cure herbal foundation my husband bought, totalcureherbsfoundation .c om has the right herbal formula to help you get rid and repair any lung conditions and cure you totally with their natural organic herbs,it class products at affordable prices. Purchase these medicines and get the generic medicines delivered in USA, UK & Australia,I wish anybody who starts smoking at a young age would realize what will eventually happen to their bodies if they continue that vile habit throughout their life.

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  7. I'm 59 years old and female. I was diagnosed a couple of years ago with COPD and I was beyond scared! My lung function test indicated 49% capacity. After having had flu a year ago, the shortness of breath, coughing and chest pains continued even after being treated with antibiotics. I've been smoking two packs a day for 36 years. Being born without a sternum caused my ribs to be curled in just one inch away from my spine, resulting to underdeveloped lungs. At age 34 I had surgery and it was fixed. Unfortunately my smoking just caused more damage to my already under developed lungs. The problem was having is that I enjoy smoking and don't want to give up! Have tried twice before and nearly went crazy and don't want to go through that again. I saw the fear in my husband and children's eyes when I told them about my condition then they start to find solution on their own to help my condition.I am an 59 now who was diagnose COPD emphysema which I know was from my years of smoking. I started smoking in school when smoking was socially acceptable. I remember when smoking was permitted in hospitals. It was not known then how dangerous cigarettes were for us, and it seemed everybody smoked but i was able to get rid of my COPD lung condition through the help of total cure herbal foundation my husband bought, totalcureherbsfoundation .c om has the right herbal formula to help you get rid and repair any lung conditions and cure you totally with their natural organic herbs,it class products at affordable prices. Purchase these medicines and get the generic medicines delivered in USA, UK & Australia,I wish anybody who starts smoking at a young age would realize what will eventually happen to their bodies if they continue that vile habit throughout their life.

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