Symptoms of emphysema and their pathogenesis
Emphysema of the lungs is usually notindependent disease, but arises against the background of the already severe violation of natural ventilation of the human respiratory system. This is a chronic nonspecific pathology of the lung tissue, in which, due to increased pressure inside the bronchioles and alveoli, their wall for a long time is overstretched, and therefore gradually loses its elasticity. All the symptoms of emphysema are formed in the syndrome of increased airiness.Thus on the roentgenogram it is possible to observeimpoverishment of the bronchovascular pattern, multiple enlightenments, deformation of the chest and descent of the diaphragm. These symptoms of emphysema are explained by increased pressure in the chest cavity and an increase in the volume of the tissue of the main organs of the respiratory system, as a result of which the patient has a swelling of the supraclavicular pits, the acquisition of a barrel-shaped chest, visible shortening of the neck and swelling of the cervical veins. In the future, cardiovascular pathology joins these changes: internal organs are exposed to oxygen starvation and dystrophy, the heart intensifies the work to compensate for this, venous congestion, common cyanosis, and then forms a "pulmonary heart".
Emphysema in children
The severe stage of this disease is considered socalled bullous emphysema. At the same time destruction in the tissue reaches such a level that many walls of neighboring alveoli and bronchioles undergo destruction, and they "merge", forming bubbles with a diameter of more than 1 cm - "bullae". Its etiological factor may be chronic inflammation in the tissue, which causes local lymphostasis, and healthy cells are constantly exposed to toxins and antibodies. In children with congenital insufficiency of α-1-antitrypsin, which supports the protection and elasticity of alveolar membranes, the symptoms of emphysema appear early, and as the disease progresses, the course of the disease only worsens. A paroxysmal cough with a purulent, difficult-to-detachable sputum, dyspnoea (often of the expiratory type), inflammatory indices in the blood, fever-all these signs should immediately disturb the pediatrician. Therefore, the symptoms of pulmonary emphysema should be detected in the shortest possible time and supported by instrumental methods (spirometry, radiography) and physical examination (percutaneously, the reduction in the border of the lungs and the boxed sound).
By pathogenesis there is a classification of twobasic forms: non-obstructive and obstructive pulmonary emphysema. Symptoms of the first appear as a compensatory reaction when a part of the lung is removed or an involuntary process in old age. The second is associated with impaired bronchial patency in chronic bronchitis or asthma, and therefore requires the treatment of a primary disease. Since emphysema is a consequence of severe structural disorders, only certain of its symptoms can be treated to alleviate the patient's condition and prevent the development of respiratory-cardiac failure.