During the diagnosis of Emphysema, the physician in charge is likely to ask the patient for details related to smoking habits. For instance the duration since the habit was started and the approximate number of cigarettes smoked per day.
Gathering of Facts
Other related questions might include:
• Passive Smoking – The physician might try and understand if the patient is being exposed to smoke either at work or home, and hence deduce if passive smoking is the possible cause.
• Environmental Factors – The physician might also be keen on checking the environment in which you live and work, for presence of airborne irritants or noxious materials, which could also be a possible cause for the symptoms.
• Air Pollution – Air pollution can be a major factor causing Emphysema. For this reason the doctor should be informed if there is reason to believe that the air that is being inhaled by the patient is polluted to a harmful degree.
• Family History - If there a family history of AAT deficiency, early onset of emphysema or non-smokers who developed emphysema in the family, the doctor should be made aware of it. Family history will help in identifying how the illness was contracted.
The doctor will also make enquiries regarding respiratory symptoms, particularly if and when shortness of breath was developed and experienced. In addition the doctor will gather information on respiratory allergies, recurrent bad colds or a persistent, heavy cough.
On completion of gathering of important facts related to smoking habits or exposure to related pollutants, the doctor will carry out a physical examination to check for typical signs of emphysema. These may include:
• Shortness of Breath -Watching for shortness of breath while performing a simple activity, such as walking into the examination room
• Chest Abnormalities - Looking at the size and shape of the chest as well as how it moves during breathing.
• Sound of the Lungs - Listening to the lungs for wheezing or loss of the normal breath sounds
• Ears, Nose & Throat - Checking the ears, nose and throat to gauge the reasons for the cough.
• Heart - Listening to the heart to check if it is healthy.
• Oxygen Levels - Checking the skin, lips and fingernails for a bluish tint that indicates low blood oxygen levels (the doctor may also directly measure the blood oxygen level with a special finger probe known as an Oximeter)
• Fingernail - Checking the fingernails for an unusual curvature ("clubbing") that sometimes occurs with chronic lung disease
• Swelling in Ankles - Feeling the ankles for swelling that indicates fluid accumulation.
It must be noted, that in many cases, the physical examination might display complete normalcy for individuals in the early stages of Emphysema.
In most people, Emphysema will be diagnosed by X-ray or lung-function tests. A regular chest X-ray may show typical changes of Emphysema including enlargement of the lungs, scarring or the formation of holes (Bullae). However, these changes may not appear until significant damage has occurred. Computed tomography (CT) scans are better for detecting the earliest changes of emphysema, and may help to diagnose the disease in younger people or those who have never smoked.
Pulmonary function testing (also known as Spirometry) is useful both to diagnose emphysema and to determine the stage of the disease. In this test the patient is asked to blow forcefully through a tube that is connected to a machine designed to measure the lung capacity. The doctor also may order specialized lung tests that may require the patient to sit inside a glass box, or slowly breathe in a mixture of different gases.
There are a couple of other tests that the doctor might issue to gain a better diagnosis.
Arterial blood gases – This test measures the levels of oxygen and carbon dioxide from blood taken by a needle from a small artery in the wrist.
Electrocardiogram (ECG) – This test looks for evidence of heart problems that may cause breathing trouble or heart strain caused by Emphysema.
In some cases if the doctor has good reason, a specific blood test to confirm the diagnosis of alpha-1 antitrypsin deficiency may be ordered. If this test is positive, the doctor is likely to recommend screening for the entire family.
Read more articles on Emphysema.