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When the tiny air sacs in the lungs which are called alveoli become damaged causing shortness of breath, respiratory failure or heart failure the affected person is said to have the disease called emphysema. In the vast majority of cases of this disease the most prominent cause has been traced to cigarette smoking. Occasionally air pollutants have been found to be the cause and there have even been rare cases where this disease was inherited because of a deficiency of of a chemical known as alpha antirypsin in the lungs. But in all cases the development of emphysema is intensified and hastened by smoking.
There are many million alveoli in each lung and the groups of tiny air sacs are found at the end of the minute air passages called the bronchioles. It is through the thin walls of the alveoli that inhaled oxygen is passed into the blood stream and carbond dioxide is taken out of the capillaries to be exhaled. It is believed that tobacco smoke, as well as other air pollutants that are known to cause enphysema cause chemicals to be released within the alveoli. These chemicals damage the walls of the tiny air sacs. While alpha antitrypsin is believed to protect against this damage, those who have a deficiency of this substance are badly affected. In the beginning the damage is slight but becomes progressively worse in heavy smokers with the alveoli bursting and creating fewer but larger sacs with less surface area. The consequences of this is the impairment of the oxygen and carbon dioxide exchange. This causes the lungs to progressively loose more and more of their elasticity further reducing their efficiency.
Over a period of many years the oxygen level in the blood begins to fall and a blood pressure rise in the pulmonary artery which is called pulmonary hypertension will develop. This then leads to an enlargement and strain on the right side of the heart which in turn causes an accumulation of fluid in the tissues. When this occurs swelling is noticable and especially in the lower legs. In some cases a sufferer finds they can compensate for the oxygen deficiency by breathing faster. Chronic bronchitis, which also occurs because of air pollutants and smoking, will often accompany emphysema. In mild cases of this disease there may be no symtoms but as it progresses there will be an increased shortness of breath. Other signs of the development of this disease might include a chronic cough, wheezing, a barrel shaped chest, a purplish blue coloring, swollen legs and rapid breathing. As the disease becomes more severe respiratory failure and heart failure may develop causing the sufferers to have even more difficulty when breathing.
Since emphysema is incurable because damaged lung tissue cannot be replace the treatments for this disease can only prevent more damage to the lungs. Doctors will begin by assuring the patient that a total and life long ban on smoking must be observed to improve the efficiency of the remaining lung tissue. A personal history will be taken, as well as blood test, chest x-rays and a pulmonary function test. Bronchodilator drugs are given to widen the bronchi and bronchioles. Corticosteroid drugs may be prescribed to aid with reducing the inflammation and diuretic drugs may be given to reduce the volume of fluid.
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