How Do Doctors Diagnose Emphysema?

Your chest feels tight, you’re out of breath much of the time, and you have a cough that won’t go away. Do you have emphysema? You can’t go on symptoms alone. See your doctor. He’ll do the following tests to find out for sure:

Medical History

Your doctor will talk to you about your health and any recent changes you might have noticed. If you have emphysema, you’ll probably have had shortness of breath, often over a period of months or years. You may also experience wheezing. You might have a cough that won’t go away, too.

Physical Exam

Your doctor will check your weight and blood pressure. He’ll listen to your heartbeat and keep an eye out for anything that seems strange or unusual.

If you have advanced emphysema, your doctor may notice that you have any of the following:

  • You have a "barrel chest" caused by larger-than-normal lungs.
  • You’re wheezing, having a hard time getting air out of your lungs.
  • Your fingertips are rounded. Doctors call this “clubbing.”
  • You purse your lips when you breathe, like you’re blowing a kiss.
  • The oxygen levels in your blood are low (hypoxemia).
  • The carbon dioxide levels in your blood are high (hypercarbia), because emphysema makes it hard to exhale properly.
  • Your lips have a blue tinge (cyanosis), another sign of low oxygen in your blood.
  • Malnutrition causes muscles to slowly waste away in advanced emphysema.

Pulmonary Function Tests (PFTs)

For this exam, you’ll sit inside an enclosed booth and breathe into a tube. This will allow your doctor to measure:

  • How much air your lungs can hold
  • How fast you can blow air out of your lungs
  • How much air stays trapped in your lungs after you exhale
  • Whether you’re able to breathe better after using medicines you inhale, such as albuterol

If you have normal lungs, you’ll likely be able to empty most of the air from them in 1 second. If you have emphysema, it’ll probably take longer.

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Chest X-ray and CT Scan

If you have advanced emphysema, your lungs will appear to be much larger than they should be. In early stages of the disease, your chest X-ray may look normal. Your doctor can’t diagnose emphysema with an X-ray alone.

A CT scan of your chest will show if the air sacs (alveoli) in your lungs have been destroyed. These make it hard for you to breathe out like normal.

Complete Blood Count

This simple blood test usually shows normal amounts of white and red blood cells. In advanced emphysema, your body produces more red blood cells to make up for decreased oxygen. These cells carry oxygen.

If your white blood cell count is higher than normal, that’s a sign that you have an infection.

WebMD Medical Reference Reviewed by Lisa Bernstein, MD on November 21, 2016

Sources

SOURCES:

News release, FDA.

American Thoracic Society: "Standards for the Diagnosis and Management of Patients with COPD."

Albert R. Clinical Respiratory Medicine, Mosby Elsevier, 2008.

American Lung Association: "Diseases A-Z: Emphysema."

National Heart Lung and Blood Institute: "Diseases and Conditions Index: COPD."

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