4 essential questions about emphysema and its diagnosis
Along with chronic bronchitis, emphysema is a serious lung disorder that is grouped under the chronic obstructive pulmonary disease (COPD). Caused by the deterioration of air sacs lining the lungs, emphysema brings up a number of breathing symptoms. These symptoms aggravate over time making normal recovery more and more difficult. There is no permanent cure for this disorder. It progresses through four stages and treatments at each stage are done to alleviate the discomfort caused by the symptoms of that stage.

How is emphysema diagnosed?

• Imaging tests – This includes chest X-rays and computerized tomography (CT) scans. Advanced emphysema is often diagnosed using chest X-rays. The CT scans give cross-sectional views of the lungs. This helps in the detection and diagnosis of emphysema.
• Lab tests – Lab tests involve blood tests. A sample of blood is taken from an artery in the wrist. The sample is tested to check whether the lungs are transferring enough oxygen in the blood and expelling carbon dioxide from the bloodstream.
• Lung-function tests – These are noninvasive tests that measure the lungs’ ability to hold air and let the air flow efficiently through the respiratory system. Using a simple device like a spirometer, a lung function test can also measure the delivery of oxygen in the bloodstream by the lungs.

What are the risk factors for emphysema?

• Gender – Men are more prone to emphysema than women. More incidences of this lung disorder have been seen in men than in women.
• Smoking – Smoking is one of the leading causes of emphysema. Second-hand smoking also increases the risk of emphysema.
• Congenital protein deficiency – Some people are born with a deficiency of a protein called alpha-1-antitrypsin (AAT). This protein is necessary for the protection of lungs. A deficiency of AAT increases the risk of emphysema.
• Prolonged exposure to toxic substances – People who are constantly exposed to toxic particles or fumes as a result of occupational hazards or environmental reasons have a high probability of developing emphysema.
• Pre-existing respiratory disorders – People suffering from asthma, allergies, and other respiratory disorders may have a predisposition toward emphysema.

How is emphysema life expectancy calculated during diagnosis?

Emphysema life expectancy is calculated using three metrics—GOLD, BODE, and FEV1.

• FEV1 – Forced Expiratory Volume in the first second (FEV1) is a metric measured using a spirometer device. It measures the amount of air a person exhales during a forced breath in the first second. Measured in percentages, the higher the FEV1 percentage is the healthier are the lungs.
• GOLD – The GOLD system was created by the Global Initiative for Chronic Obstructive Lung Disease. This system is used by doctors for emphysema staging and determines emphysema life expectancy. Using FEV1 reading obtained from a pulmonary function test, the severity of emphysema can be determined.
• BODE – The BODE index measures the impact of emphysema on a person’s life. It is measured using four parameters—body mass index, exercise capacity, airflow limitation, and breathlessness or dyspnea. These parameters are measured using a series of tests that involve physical tests and questionnaires.

What are the different stages of emphysema?

• Stage 1 – This is a very mild stage of emphysema. In the GOLD system, it is labeled as GOLD 1 or 2. The FEV1 is 80%. It indicates that there have been no episodes of flare-ups in past one year and there has been no need for hospitalization.
• Stage 2 – Also labeled as GOLD 1 or 2, the symptoms are moderate. The FEV1 is between 50% and 80%. Patients frequently experience shortness of breath, wheezing, and coughing. In this stage, there may be one episode of a flare-up
• Stage 3 – The lungs are severely affected with limited airflow in and out of the lungs at this stage. The FEV1 level is between 30% and 50%. In the GOLD system, this stage can be labeled as GOLD 3 or 4.
• Stage 4 – The lungs are extremely affected, and it becomes quite difficult to breathe. The FEV1 level is nearly below 30%. The patient may have experienced at least two flare-ups in the past year. The blood oxygen levels are quite low at this stage. In the GOLD system, this stage can be labeled as GOLD 3 or 4.

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