Emphysema is a disorder of the airways characterized by the abnormal enlargement of air spaces of distal bronchioles, accompanied by destructive and morphological changes of alveolar walls In turn, it creates the conditions for the development of a wide array of other pulmonary and cardiovascular diseases. The following research focuses on the analysis of the pathologies that may occur in the course of emphysema.
One of the common symptoms of emphysema is the barrel chest facilitated by the following pathological process. During the disease, the bronchi become narrower, primarily due to the spasm of bronchial muscles, the swelling of mucous membrane bronchi, the presence of viscous sputum, and the squeezing of the inflammatory or scar tissue. The airflow resistance during breathing heavily depends on the radius of the bronchus, meaning that it increases considerably. In this case, the passive expiration, which does not require direct muscular effort, is replaced by the active one to ensure the necessary lung ventilation. The narrowing of the bronchi also leads to an increase in the pressure within the chest, resulting in the squeezing of the small bronchial tubes by the alveoli that surround them. In turn, ones ability to exhale is limited, leading to increased residual lung volume. To compensate for it, the shape of the patient's chest changes, becoming close to the one during maximum ventilation and increasing the radius of the bronchi as well as the tension of the alveoli . As a result, the chest becomes more pronounced, resembling a barrel.
In the case of emphysema, the condition of arterial gases also depends on the pathological processes that occur in the course of the disease. In particular, the changes in the alveoli lead to the severe shortness of breath due to the drastic reduction of respiratory lung surface and capillary bed. However, the ratio of ventilation and perfusion remains relatively stable, with the arterial gas considered normal On the other hand, the changes in bronchi result in the hypoventilation of alveoli, leading to alveolar hypoxemia. As a result, the share of oxygen in the blood is lowered due to the reduction of air exchange in the lungs. In turn, the patient is likely to suffer from hypercapnia a condition caused by an excessive amount of carbon dioxide in the blood. Thus, the arterial gases become abnormal.
The pathological changes in the lung tissue during emphysema provide the basis for the development of several complications. First of all, the damaged network of capillaries in the lungs entails the development of pulmonary hypertension and the increased load on the cardiovascular system, which may result in heart failure accompanied by ascites and hepatomegaly. Moreover, the patients are at the risk of developing spontaneous pneumothorax, requiring the drainage of pleural cavity and air aspiration. Additionally, emphysema makes the lungs much more vulnerable to bacterial invasion. Thus, infectious diseases of the respiratory system in people with this pathology often turn into chronic forms with the pockets of persistent infection, which significantly complicates the treatment . As a result, it is imperative to pay particular attention to the antibiotic therapy even for minor respiratory infections to prevent their chronicity.
Thus, emphysema is a disorder that requires immediate treatment, before any significant changes in the lung tissue occur. This statement is supported by the fact that most of its complications result in a patient's disability. Therefore, to ensure the patient's direct involvement in the treatment, the latter must understand and be aware of the seriousness of the disease and its possible consequences.
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