Emphysema is a chronic lung condition in which the walls of the tiny air sacs, called alveoli, are damaged. The lungs lose elasticity and air can become trapped, making it harder to breathe out. Emphysema is one of the main conditions included under chronic obstructive pulmonary disease (COPD).
Symptoms
Emphysema often develops gradually. Common symptoms include:
- shortness of breath, especially during physical activity
- persistent cough
- wheezing
- difficulty taking a deep breath
- chest tightness
- reduced exercise tolerance and fatigue
As lung damage becomes more advanced, breathlessness may occur during ordinary daily activities or at rest.
Causes and risk factors
Cigarette smoking is a major cause of COPD and emphysema. Other risks include secondhand smoke and long-term exposure to workplace dust, fumes, indoor smoke or air pollution. Some people develop emphysema despite never smoking.
A less common inherited condition called alpha-1 antitrypsin deficiency can increase the risk of emphysema, sometimes at a younger age. Testing may be considered when emphysema develops unusually early, occurs without typical exposures or runs in the family.
Diagnosis
A healthcare professional will review symptoms, smoking and exposure history, and family history. Spirometry is an important lung function test used to detect persistent airflow obstruction. It measures how much air you can breathe out and how quickly.
Other tests may include pulse oximetry, additional lung function tests, blood tests and chest imaging. A chest X-ray can help assess the lungs and exclude other causes of symptoms, while CT imaging can provide more detailed information when needed.
Treatment
Damage to the air sacs cannot currently be reversed, but treatment can reduce symptoms, improve daily function and help prevent complications and flare-ups.
- Stopping smoking: for people who smoke, quitting is the most important step and can slow further loss of lung function.
- Inhaled medicines: bronchodilators can help open the airways. Other inhaled medicines may be recommended depending on symptoms and flare-up history.
- Pulmonary rehabilitation: individualized exercise, education and breathing strategies can improve function and quality of life.
- Vaccination: recommended respiratory vaccines can reduce the risk of infections that may cause serious COPD complications.
- Oxygen therapy: supplemental oxygen may be prescribed for selected people whose blood oxygen level remains low.
People with severe emphysema may sometimes be assessed for specialist procedures such as lung volume reduction treatment or lung transplantation. These options are suitable only for carefully selected patients.
Flare-ups
A COPD flare-up can cause a noticeable increase in breathlessness, coughing or wheezing, or a change in mucus. Contact the healthcare team promptly if symptoms become significantly worse and follow any written COPD action plan.
When to seek urgent help
Seek emergency medical care for severe or rapidly worsening breathing difficulty, blue or gray lips or skin, confusion, collapse, severe chest pain or coughing up a significant amount of blood. Use your local emergency medical service when symptoms are severe or life-threatening.
Living with emphysema
Regular follow-up can help monitor symptoms, lung function, inhaler technique, oxygen needs and flare-ups. Staying physically active within your abilities, avoiding tobacco smoke and lung irritants, and following the treatment plan can help maintain function and quality of life.
Related topics
Sources
- CDC: About COPD
- CDC: Cigarettes and COPD
- National Heart, Lung, and Blood Institute: Tests for Lung Disease
Last reviewed: 4 September 2026. This page provides general health information and does not replace individual medical advice.