How Is Emphysema Diagnosed?

Making a Diagnosis

A diagnosis of emphysema cannot be made on symptoms alone. A careful history focusing on the number and duration of these symptoms, as well as smoking and occupational histories, is basic to diagnosing emphysema.
 
The physician will thoroughly examine the chest, observe breathing patterns, and monitor how hard the person is working to breathe. A thorough exam will also include noting the degree of over-inflation of the lungs, listening to the chest with a stethoscope to hear the airflow in and out of the lungs, and listening to heart sounds to determine their rate and rhythm (as well as signs of heart strain that may accompany advanced stages of emphysema).
 
In addition, routine lung function tests can determine several characteristics and capabilities of the lungs. The following tests can identify various stages of emphysema:
 
  • Spirometry. Through a tube connected to a machine that records airflow and capacity, the patient takes a deep breath and blows it out as quickly as possible. Measuring the amount of air that can be forced out in one second and the total amount of air that can be exhaled is the best way to determine the amount of airway obstruction.
     
  • Arterial blood gas (ABG). An ABG is done by analyzing blood from an artery for amounts of carbon dioxide and oxygen. This test is often used to assess more advanced stages of emphysema and to determine whether or not a person needs extra oxygen.
     
  • Pulse oximetry. A special light (clipped onto the finger or earlobe) can indirectly measure the amount of oxygen in the blood.
     
  • X-rays. X-rays are not often helpful in early-stage diagnosis of emphysema, but in moderate to severe cases, a reasonably accurate diagnosis can be made with the plain chest x-ray and computerized axial tomography (CAT) scanning. Some of the more common appearances on the chest x-ray include flattened diaphragms, loss of blood vessel markings, and the appearance of a reduced size of the heart.
     
These and other test results are then compared to values considered healthy for various age groups, heights, weights, genders, and races.
 

Information on Emphysema

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