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Emphysema is an irreversible condition, wherein air spaces in the lungs are enlarged, specifically those beyond the terminal bronchioles and most notably in the alveoli resulting in alveolar wall damage and airflow obstruction. This is most common among chronic smokers. (Braun, 2007)
The development of an inflammation in the small airways is mainly the source of obstruction. In moderate to severe emphysema, the primary cause of obstruction is the loss of elastic recoil in the alveoli. Along with the airway obstruction, vascular changes in the lungs can be noted that will make the lining of the arteries and arterioles thicker and fibrotic, resulting to the destruction of the alveoli and capillaries. Elasticity is very crucial in the alveoli. Loss of elasticity will affect its ability of contract in order move the air back out of the body. The airspaces will become enlarged and ineffective resulting to hypoxemia, hypoxia and hypercapnia. At this moment, the body is unable to function well to take in oxygen and release carbon dioxide. The air remains trapped as the alveolar wall collapse. This will lead to air trapping that if a person takes a deep breath it will only release half of the air cause the lungs hyper inflated leading to the condition called barrel chest. (Braun, 2007)
As the alveoli becomes further damaged, progression of hypoxemia and hypoxia will lead to decreased oxygen level in the arterial blood leading to respiratory acidosis caused by the carbon dioxide retention. (Braun, 2007)
If the lungs are already compromised patient will develop complications such as heart problem resulting from the pressure in the arteries from the heart and lung leading to the condition called cor pulmonale. As the emphysema progresses large holes in the lung (giant bullae) can develop. This condition develops an empty space in the lung causing a reduced amount of space available for the lungs to expand increasing the risk of the development of pneumothorax. (Mayo clinic, 2014)
Reference:
Braun, C.A., & Anderson, C.M., (2007). Pathophysiology: Functional alterations in human health. Lippincott Williams & Wilkins.
Mayo Clinic Staff. (2014). Emphysema. Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseasesconditions/emphysema/basics/complications/con20014218
