Why do you get emphysema? Know the pathological causes early

There are many types of emphysema, the most common ones are senile emphysema and interstitial emphysema. Emphysema generally develops slowly, and patients will have chronic symptoms of cough and sputum, and will also experience difficulty breathing after excessive fatigue. The cause must be found in time and targeted treatment must be given.

1. Pathological causes

Studies on the relationship between α1-antitrypsin deficiency and emphysema suggest that emphysema is caused by an imbalance in the levels of proteases and antiproteases in the lungs, which destroys the alveolar septa. A large number of animal models of emphysema support this hypothesis. Studies on human emphysema have demonstrated that elastin concentrations are increased in patients with emphysema. Smoking can increase elastin dissolving activity, inhibit the infiltration of lung fibroblasts, increase tissue sensitivity to elastase, and inhibit the activity of anti-elastase. These findings support the view that smoking disrupts the balance between elastase and anti-elastase, thereby causing damage to the microstructure of the lung and causing emphysema.

2. Symptoms and Signs

The disease develops slowly, and most patients have a history of chronic cough and sputum. The early symptoms are not obvious, or you may feel shortness of breath when you are tired. As the disease progresses, the shortness of breath gradually worsens, making it difficult to perform the original work. When chronic bronchitis is complicated by obstructive pulmonary emphysema, gradually worsening breathing difficulties occur on the basis of the original symptoms such as cough and sputum. When secondary infection occurs, symptoms of respiratory failure such as chest tightness, shortness of breath, cyanosis, headache, drowsiness, and confusion may appear. When emphysema worsens, a barrel chest appears, respiratory movements weaken, exhalation is prolonged, vocal trills weaken or disappear, percussion becomes hyperresonant, the boundaries of cardiac dullness shrink or disappear, the boundaries of liver dullness descend, heart sounds are distant, breath sounds weaken, and there are moist rales in the lungs. Some patients developed complications: spontaneous pneumothorax; acute lung infection; chronic cor pulmonale.

Mild emphysema often causes no abnormal signs. When emphysema worsens, the anterior-posterior diameter of the thorax increases, the appearance becomes barrel-shaped, the spine becomes kyphotic, the shoulders and clavicle are lifted, the intercostal spaces become full, and the movement of the ribs and clavicle decreases. Vocal fremitus weakens, percussion becomes hyperresonant, the boundary of cardiac dullness shrinks or disappears, and the boundary of liver dullness decreases. Breath sounds and vocal fremitus are weakened, and exhalation is prolonged. Sometimes dry and wet rales can be heard at the lung base, and heart sounds are distant. Patients with severe emphysema may have rapid and shallow breathing, with almost no breath sounds, even when at rest. Cyanosis may occur, and when combined with cor pulmonale and right heart failure, signs such as distended neck veins, ascites, hepatomegaly, and pitting edema may appear.