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Emphysema is a progressive lung disease in which the small air sacs and airways in the lungs become damaged, making breathing a frustrating and painful process.


Symptoms may include:

  • Shortness of breath
  • Chronic cough
  • Limited ability to exercise comfortably
  • Fatigue


The most common cause of emphysema is smoking, particularly cigarette smoking. Tobacco can paralyze the tiny hairs (called cilia) that line bronchial tubes and usually sweep irritants and germs out of airways.

Other risk factors include:

  • Deficiency in the alpha-1 atritrypsin (AAt) protein, which protects lung structures. Some people carry a single defective AAt gene and some people carry two. Symptoms in either of these two types may begin between 32 and 41 years of age.
  • Exposure to secondhand smoke
  • Age, since emphysema most often develops between the age 50-60
  • Frequent exposure to chemicals, such as car exhaust
  • HIV infection
  • Some rare connective tissue disorders


One or more of the following tools may be used to diagnose emphysema:

  • Chest X-rays 
  • Computed tomography (CT) scans Arterial blood gas analysis 
  • Pulse oximetry 


Treatment methods vary based on the unique situation, but the most important treatment typically is quitting smoking. Using a combination of cessation techniques—such as support groups, nicotine patches or replacement drugs, counseling, and relapse prevention—usually brings about the most positive results.

Other treatments include:

  • Bronchodilators, a class of drugs that are either inhaled as a spray or taken as a pill, help open airways and allow for easier breathing
  • Steroids to relieve symptoms
  • Oxygen supplementation therapy
  • Infusions of AAt
  • Antiobiotics
  • Surgery may involve removing small parts of damaged lung tissue or, in the most severe cases, lung transplantation
  • Bronchial valves decrease the size of overly inflated lungs

Pulmonary rehabilitation is often a key part of treatment, too. It includes education, exercise training, and behavioral intervention to help restore a better level of function and comfort.


Call: 617.638.5600
Fax: 617.638.7382

Boston Medical Center
Center for Thoracic Surgery
Moakley Building
830 Harrison Avenue, 3rd Floor
Boston, MA 02118

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Fax: 617.638.7382

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