Emphysema

Symptoms:

• a chronic cough
• a bluish coloration of the skin caused by lack of oxygen
• shortness of breath (chronic)
• shortness of breath with mild exertion
• wheezing

Additional symptoms that may be associated with this disease:

• nasal flaring
• eyes, bulging
• vision abnormalities
• dizziness
• breathing, absent temporarily
• breathing difficulty, lying down
• anxiety, stress, and tension
• ankle, feet, and leg swelling
• unintentional weight loss
• headache (may be worse in the morning)
• impotence
• fatigue
• impaired ability to concentrate
• excessive daytime sleepiness
• difficulty falling asleep or staying asleep (insomnia)
• awakening many times at night
• awakening from sleep not rested
• irritability or poor temper control
• memory loss
• clubbing of the fingers or toes

Signs and tests:

A physical examination shows decreased breath sounds, wheezing, abnormal breath sounds (rales), and prolonged exhalation (exhalation takes more than twice as long as inspiration). The chest may appear enlarged on the right side, or there may be an increased front-to-back diameter of the chest (barrel shaped chest). There may be signs of chronic sleep deprivation, or signs of chronically insufficient oxygen levels in the blood.

These tests help confirm the diagnosis:

• arterial blood gases showing reduced oxygen
• serum alpha-1 antitrypsin level showing a deficiency
• chest X-ray
• pulmonary function tests

This disease may also alter the results of the following tests:

• urine pH
• a pulmonary ventilation/perfusion scan
• a chest MRI
• a CEA level (not useful in children)