Emphysema

Emphysema, a chronic obstructive pulmonary disease (COPD), most often develops after years of smoking (including marijuana, vaping and e-cigarettes). But this ongoing condition can also start from infections or exposure to pollution and chemicals. It can also grow out of inherited (born with it) factors.

This condition damages the fragile air sacs (alveoli) in your lungs that move oxygen to your blood and carbon dioxide out of your lungs. When alveoli are damaged, you can get large air pockets in your lungs. And it can be hard to get this stale air out of your lungs — and fresh air in. Instead, it can be tough to breathe. And you feel short of breath (dyspnea).

Emphysema can get worse without treatment. And many people don’t notice symptoms until the condition has damaged more than half of their lung tissue. They may chalk up early signs like tiredness and gradual shortness of breath to other things. That’s why it’s important to check out these warning signs quickly. Particularly if you smoke or have worked in places with pollutant or chemical exposure.

What to expect at your first visit

It can be unnerving when you can’t breathe right. We’re here to help figure out why that’s happening. One of the most important steps is to hear you tell your story.

That’s why your provider will spend time getting to know you during your first visit. They’ll listen to your concerns, answer your questions and ask you a few of their own, like:

• What brings you here today?
• What kind of symptoms are you having?
• How long have you had them?
• Have they grown worse?
• What effect do they have on your life?
• Do you have other health conditions?
• Does anyone in your family have breathing problems?
• Have you had any tests before this appointment?

Your provider can’t make a diagnosis on symptoms alone because emphysema shares many symptoms with other conditions, like heart disease. So, they’ll also do a physical exam and order tests to help confirm a diagnosis.

Testing for emphysema

We use different tests to diagnose emphysema. You may have:

• Chest x-ray.
• CT scan.
• Pulmonary function testing.
• Spirometry.
• Arterial blood gas (ABG).
• CO2 blood test.
• Electrocardiogram (EKG).
• Genetic tests.

Meet Our Emphysema Team

Cleveland Clinic focuses on team-based care. If you choose to come here for treatment, you’ll have a care team of different providers from different specialties that work together. Your team may include:

• Pulmonologists.
• Cardiologists.
• Radiologists.
• Pathologists.
• Cardiothoracic surgeons.
• Nurse practitioners.
• Respiratory therapists (providers who help sustain or strengthen your lung’s capabilities through therapy).
• Genetic counselors.

Your care team will work together to pinpoint a diagnosis and build a highly personalized treatment plan to help you manage your emphysema.

The main focus of any emphysema treatment is to slow down its progress and keep your healthy lung tissue working as best it can. We plan your treatment around how bad your condition is and your goals for managing it.

The first thing your provider will do is recommend that you quit smoking of any kind. We can help you find the best, most effective ways to quit. And we’ll support you as you move through the program. We’ll also recommend a combination of different therapies, like:

Medications

There are different types of medications that can help manage and relieve emphysema symptoms, like:

• Bronchodilators: Relax the muscles around your airways to help you breathe better.
• Corticosteroids: Reduce airway swelling and mucus production.
• Antibiotics: Treat bacterial infections like pneumonia and bronchitis.
• Anti-inflammatory drugs: Reduce mucus and prevent exacerbations (symptoms getting worse).

Pulmonary rehabilitation

Cleveland Clinic offers pulmonary rehabilitation for people with lung conditions, like emphysema. Our therapists teach you new skills and exercises to increase your strength and help you breathe easier. And you may find it’s easier to do everyday activities without gasping for breath or getting exhausted.

Oxygen therapy

If we prescribe oxygen therapy, you’ll use an oxygen machine to get more oxygen to your lungs and bloodstream.

Surgery

For really bad emphysema, your care team may recommend surgery to remove diseased tissue and release air pockets to help you breathe better. Your provider will let you know if surgery is a good option for you as they build your treatment plan.

If they feel surgery could help, you may have minimally invasive lung volume reduction surgery to remove pressure on your breathing muscles. If they recommend bronchoscopic lung volume reduction, they’ll place a one-way valve in your airways to help air leave pockets in your lungs. Or they may feel you could benefit from a lung resection to remove all or part of your damaged lung.

Lung transplant

If your lungs don’t respond to other treatments, we may explore a lung transplant. This surgery replaces your damaged lungs with healthy donor lungs.

Taking the Next Step

When you have emphysema, taking each breath can be tough and exhausting. Cleveland Clinic’s expert healthcare providers are here to help you learn how to manage this chronic condition. From medications to pulmonary rehab to surgery, we can move you toward getting back to living your everyday life and breathing easier.