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Emphysema

Table of Contents

Emphysema

Pulmonary emphysema

Emphysema is a type of COPD involving damage to the air sacs (alveoli) in the lungs. Emphysema makes it hard to catch your breath. The most common cause of emphysema is smoking. Learn about symptoms and treatment.

Emphysema on Left Lung

Image by TheVisuaMD

Summary

Emphysema

Image by Blausen Medical Communications, Inc.

Emphysema

Emphysema

Image by Blausen Medical Communications, Inc.

What Is Emphysema?

Emphysema is a type of COPD (chronic obstructive pulmonary disease). COPD is a group of lung diseases that make it hard to breathe and get worse over time. The other main type of COPD is chronic bronchitis. Most people with COPD have both emphysema and chronic bronchitis, but how severe each type is can be different from person to person.

Emphysema affects the air sacs in your lungs. Normally, these sacs are elastic or stretchy. When you breathe in, each air sac fills up with air, like a small balloon. When you breathe out, the air sacs deflate, and the air goes out.

In emphysema, the walls between many of the air sacs in the lungs are damaged. This causes the air sacs to lose their shape and become floppy. The damage also can destroy the walls of the air sacs, leading to fewer and larger air sacs instead of many tiny ones. This makes it harder for your lungs to move oxygen in and carbon dioxide out of your body.

Source: National Heart, Lung, and Blood Institute (NHLBI)

Additional Materials (21)

Panlobular emphysema

There is diffuse destruction of lung tissue throughout the secondary lobules without any evidence of localization around centrally located bronchovascular bundles as seen in centrilobular emphysema. Smoking appears to potentiate the development of panlobular emphysema in individuals with alpha-1 antitrypsin deficiency.

Image by Yale Rosen from USA

What is emphysema? | Respiratory system diseases | NCLEX-RN | Khan Academy

Video by khanacademymedicine/YouTube

Emphysema - Introduction, Types, Symptoms, Diagnosis

Video by Armando Hasudungan/YouTube

COPD and emphysema

Video by Chest Heart & Stroke Scotland/YouTube

Lung Compliance | Surface Tension | Emphysema | Respiratory Physiology

Video by Medicosis Perfectionalis/YouTube

Smoking and emphysema

Video by Chest Heart & Stroke Scotland/YouTube

Chronic Bronchitis VS Emphysema | Comparison | Pulmonology

Video by Medicosis Perfectionalis/YouTube

Emphysema - an Osmosis preview

Video by Osmosis/YouTube

Emphysema | COPD | Pulmonary Medicine

Video by Medicosis Perfectionalis/YouTube

Understanding Chronic Obstructive Pulmonary Disease (COPD#1)

Video by Healthguru/YouTube

Emphysema - Pathophysiology (COPD)

Video by Armando Hasudungan/YouTube

Centriacinar emphysema vs panacinar emphysema | NCLEX-RN | Khan Academy

Video by khanacademymedicine/YouTube

Emphysema pathophysiology | Respiratory system diseases | NCLEX-RN | Khan Academy

Video by khanacademymedicine/YouTube

Emphysema Treatment

Video by Armando Hasudungan/YouTube

Emphysema diagnosis | Respiratory system diseases | NCLEX-RN | Khan Academy

Video by khanacademymedicine/YouTube

Mayo Clinic Minute: Minimally invasive procedure for emphysema

Video by Mayo Clinic/YouTube

Chronic Bronchitis vs Emphysema Pathophysiology, Treatment, Nursing, Symptoms | COPD NCLEX Review

Video by RegisteredNurseRN/YouTube

Emphysema vs Bronchitis

Video by Lee Health/YouTube

Emphysema treatment | Respiratory system diseases | NCLEX-RN | Khan Academy

Video by khanacademymedicine/YouTube

EMPHYSEMA, Causes, Signs and Symptoms, Diagnosis and Treatment.

Video by Medical Centric/YouTube

Emphysema: Types, Pathogenesis and morphology

Video by Pathology Simplified/YouTube

Panlobular emphysema

Yale Rosen from USA

10:55

What is emphysema? | Respiratory system diseases | NCLEX-RN | Khan Academy

khanacademymedicine/YouTube

10:11

Emphysema - Introduction, Types, Symptoms, Diagnosis

Armando Hasudungan/YouTube

0:24

COPD and emphysema

Chest Heart & Stroke Scotland/YouTube

15:42

Lung Compliance | Surface Tension | Emphysema | Respiratory Physiology

Medicosis Perfectionalis/YouTube

0:18

Smoking and emphysema

Chest Heart & Stroke Scotland/YouTube

5:55

Chronic Bronchitis VS Emphysema | Comparison | Pulmonology

Medicosis Perfectionalis/YouTube

0:55

Emphysema - an Osmosis preview

Osmosis/YouTube

22:08

Emphysema | COPD | Pulmonary Medicine

Medicosis Perfectionalis/YouTube

3:14

Understanding Chronic Obstructive Pulmonary Disease (COPD#1)

Healthguru/YouTube

9:48

Emphysema - Pathophysiology (COPD)

Armando Hasudungan/YouTube

4:43

Centriacinar emphysema vs panacinar emphysema | NCLEX-RN | Khan Academy

khanacademymedicine/YouTube

5:40

Emphysema pathophysiology | Respiratory system diseases | NCLEX-RN | Khan Academy

khanacademymedicine/YouTube

5:59

Emphysema Treatment

Armando Hasudungan/YouTube

7:27

Emphysema diagnosis | Respiratory system diseases | NCLEX-RN | Khan Academy

khanacademymedicine/YouTube

1:00

Mayo Clinic Minute: Minimally invasive procedure for emphysema

Mayo Clinic/YouTube

10:22

Chronic Bronchitis vs Emphysema Pathophysiology, Treatment, Nursing, Symptoms | COPD NCLEX Review

RegisteredNurseRN/YouTube

1:56

Emphysema vs Bronchitis

Lee Health/YouTube

10:21

Emphysema treatment | Respiratory system diseases | NCLEX-RN | Khan Academy

khanacademymedicine/YouTube

4:25

EMPHYSEMA, Causes, Signs and Symptoms, Diagnosis and Treatment.

Medical Centric/YouTube

10:01

Emphysema: Types, Pathogenesis and morphology

Pathology Simplified/YouTube

Risk Factors

Air Pollution

Image by Ioannis Ioannidis

Air Pollution

Air Pollution

Image by Ioannis Ioannidis

Who Is at Risk for Emphysema?

The risk factors for emphysema include

Smoking. This the main risk factor. Up to 75 percent of people who have emphysema smoke or used to smoke.
Long-term exposure to other lung irritants, such as secondhand smoke, air pollution, and chemical fumes and dusts from the environment or workplace.
Age. Most people who have emphysema are at least 40 years old when their symptoms begin.
Genetics. This includes alpha-1 antitrypsin deficiency, which is a genetic condition. Also, smokers who get emphysema are more likely to get it if they have a family history of COPD.

Source: National Heart, Lung, and Blood Institute (NHLBI)

Additional Materials (2)

Air Pollution

Air Pollution

Image by Pixource

Pollution, Disaster, Environment

Image by TheDigitalArtist/Pixabay

Air Pollution

Pixource

Pollution, Disaster, Environment

TheDigitalArtist/Pixabay

Causes

Smoking and Exposed Respiratory System

Image by ThevisualMD

Smoking and Exposed Respiratory System

Smoking and Exposed Respiratory System

Image by ThevisualMD

What Causes Emphysema?

The cause of emphysema is usually long-term exposure to irritants that damage your lungs and the airways. In the United States, cigarette smoke is the main cause. Pipe, cigar, and other types of tobacco smoke can also cause emphysema, especially if you inhale them.

Exposure to other inhaled irritants can contribute to emphysema. These include secondhand smoke, air pollution, and chemical fumes or dusts from the environment or workplace.

Rarely, a genetic condition called alpha-1 antitrypsin deficiency can play a role in causing emphysema.

Source: National Heart, Lung, and Blood Institute (NHLBI)

Additional Materials (1)

Emphysema | COPD | Pulmonary Medicine

Video by Medicosis Perfectionalis/YouTube

22:08

Emphysema | COPD | Pulmonary Medicine

Medicosis Perfectionalis/YouTube

Symptoms

Depiction of a woman suffering from Emphysema, a type of Chronic Obstructive Pulmonary Disease

Image by https://www.myupchar.com

Depiction of a woman suffering from Emphysema, a type of Chronic Obstructive Pulmonary Disease

This is a depiction of a woman suffering from Emphysema, a type of Chronic Obstructive Pulmonary Disease. Normal alveoli have been shown in comparison with damaged alveoli.

Image by https://www.myupchar.com

What Are the Symptoms of Emphysema?

At first, you may have no symptoms or only mild symptoms. As the disease gets worse, your symptoms usually become more severe. They can include

Frequent coughing or wheezing
A cough that produces a lot mucus
Shortness of breath, especially with physical activity
A whistling or squeaky sound when you breathe
Tightness in your chest

Some people with emphysema get frequent respiratory infections such as colds and the flu. In severe cases, emphysema can cause weight loss, weakness in your lower muscles, and swelling in your ankles, feet, or legs.

Source: National Heart, Lung, and Blood Institute (NHLBI)

Additional Materials (1)

Chronic Bronchitis VS Emphysema | Comparison | Pulmonology

Video by Medicosis Perfectionalis/YouTube

5:55

Chronic Bronchitis VS Emphysema | Comparison | Pulmonology

Medicosis Perfectionalis/YouTube

Diagnosis

Emphysema due to alpha 1-antitrypsin deficiency

Image by James Heilman, MD

Emphysema due to alpha 1-antitrypsin deficiency

Emphysema due to alpha 1-antitrypsin deficiency

Image by James Heilman, MD

How Is Emphysema Diagnosed?

To make a diagnosis, your health care provider

Will ask about your medical history and family history
Will ask about your symptoms
May do lab tests, such as lung function tests, a chest x-ray or CT scan, and blood tests

Source: National Heart, Lung, and Blood Institute (NHLBI)

Additional Materials (3)

Emphysema, centrilobular

Advanced centrilobular emphysema with total involvement of secondary lung lobules on the left and centrilobular localization still apparent on the right.

Image by Yale Rosen from USA/Wikimedia

Panlobular emphysema

There is diffuse destruction of lung tissue throughout the secondary lobules without any evidence of localization around centrally located bronchovascular bundles as seen in centrilobular emphysema. Smoking appears to potentiate the development of panlobular emphysema in individuals with alpha-1 antitrypsin deficiency.

Image by Yale Rosen from USA

Emphysema - Introduction, Types, Symptoms, Diagnosis

Video by Armando Hasudungan/YouTube

Emphysema, centrilobular

Yale Rosen from USA/Wikimedia

Panlobular emphysema

Yale Rosen from USA

10:11

Emphysema - Introduction, Types, Symptoms, Diagnosis

Armando Hasudungan/YouTube

Lung Function Tests

Lung Function Tests

Also called: Pulmonary Function Tests, PFTs, Respiratory Function Tests

Lung function tests are a group of tests that check to see if your lungs are working right. For most tests, you will breathe into a mouthpiece while a machine measures how well your lungs are working.

Lung Function Tests

Also called: Pulmonary Function Tests, PFTs, Respiratory Function Tests

Lung function tests are a group of tests that check to see if your lungs are working right. For most tests, you will breathe into a mouthpiece while a machine measures how well your lungs are working.

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Use the slider below to see how your results affect your health.
Your result is Normal.
On a spirogram, the breath flow is usually shown on the X axis and expressed in liters per second, while the breath volume is shown on the Y axis and expressed in liters. A normal spirogram reveals a healthy curve that shows a jump right after the start of the expiration, then a steady and quick raise to a sharp peak, and finally a smooth and slow fall.
Related conditions
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Use the slider below to see how your results affect your health.
%
40
60
75
140
Your result is Normal.
A normal DLCO indicates a normal lung function. DLCO is a calculated, derived value that indirectly assesses the ability of the lungs to "transfer" oxygen to blood through the use of a test gas (namely, CO) that has a greater affinity for blood hemoglobin. A normal result does not completely rule out lung disease.
Related conditions
{"label":"Six-minute walk reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":0,"max":400},"text":"A low score correlates with lower lung function. If your score declines, compared to previous results, it may suggest that your condition is progressing.","conditions":["Alzheimer\u2019s disease","Heart diseases","Huntington disease","Lung diseases","Multiple sclerosis","Parkinson disease","Spinal cord injury","Stroke"]},{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":400,"max":700},"text":"The score range for healthy adults is 400\u2013700 m. However, factors such as age, sex, and underlying health conditions can alter this value. The higher your score, the better is your exercise tolerance. A substantial increase in your score, compared to previous results, may indicate that your treatment is effective.","conditions":[]}],"units":[{"printSymbol":"m","code":"m","name":"meter"}],"value":550,"disclaimer":"Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are \"within normal limits.\""}[{"abnormal":0},{"normal":0}]
Use the slider below to see how your results affect your health.
m
400
Your result is Normal.
The score range for healthy adults is 400–700 m. However, factors such as age, sex, and underlying health conditions can alter this value. The higher your score, the better is your exercise tolerance. A substantial increase in your score, compared to previous results, may indicate that your treatment is effective.
Related conditions
Lung function tests are a group of tests that check how well your lungs are working. These tests are also called pulmonary function tests, or PFTs. They may be used with other tests and information to help diagnose and monitor certain lung diseases.
There are many types of lung function tests. Most of them involve breathing through a mouthpiece. The mouthpiece is connected to a device that makes different types of measurements, such as:
- How much air your lungs can hold
- How well you move air in and out of your lungs when you breathe
- How well your lungs absorb oxygen from the air you breathe and move it into your blood
Lung function tests also help check the health of your airways. Your airways are the parts of your body that carry air to your lungs, including your nose, throat, trachea (windpipe), and bronchial tubes that connect your windpipe to each lung.
Common lung function tests include:
- Spirometry. This lung function test is used the most. A spirometry test measures how much air you breathe out and how fast you can blow air out of your lungs.
- Lung volume test, also called as body plethysmography. This test is the most accurate way to measure the amount of air your lungs can hold. It also measures the amount of air that remains in your lungs after you exhale as much as you can.
- Lung diffusion capacity test. This test measures how well your lungs deliver oxygen to your blood from the air you breathe.
- Exercise tests. There are different types of tests that measure how well your lungs work when you are active, including:
  Six minute walk test
  Cardiopulmonary (heart and lung) exercise test (CPET)
Your health care provider may order one or more lung function tests, depending on the reason you need to be tested.
Other names: pulmonary function tests, PFTs
Lung function tests are often used to:
- Help diagnose and monitor lung diseases, including:
  Asthma
  COPD (chronic obstructive pulmonary disease)
  Emphysema
  Pulmonary fibrosis
  Pulmonary hypertension
- Guide decisions about treating certain lung diseases with medicine
- Help diagnose and monitor certain diseases that can affect the lungs, such as scleroderma or sarcoidosis
- Check lung function before surgery
- Check for lung damage from exposure to chemicals or other substances at home or work
Lung function tests are done for many different reasons. You may need testing if you:
- Have signs and/or symptoms of a breathing problem such as:
  Shortness of breath
  Wheezing
  Coughing
  A tight feeling in your chest or trouble breathing deeply
  An abnormal chest x-ray
- Have a lung condition or another type of condition that could damage your lungs
- Have been exposed to substances that can cause lung damage, such as asbestos, radiation, or certain medicines
- Are going to have surgery
Your provider may also order a lung function test as part of your routine exam.
There are different ways to do each type of lung function test. But the basic steps are about the same.
For a spirometry test:
- You'll sit on a chair with a soft clip on your nose. The clip makes sure you breathe only through your mouth.
- You'll place your lips tightly around a mouthpiece that's connected to a device called a spirometer.
- You'll be told to take a deep breath in and then blow it out into the mouthpiece as hard as you can. The spirometer will measure how much air you breathe out and how fast you blow it out.
- You may be given medicine to inhale (breath in) that opens your airways. Then you'll blow into the tube again to see if the medicine helps you blow out more air faster.
For a lung volume (body plethysmography) test:
- You'll sit in a small, airtight room with clear walls. It looks like a telephone booth.
- You'll wear a soft clip on your nose to make sure you breathe only through your mouth.
- You'll place your lips tightly around a mouthpiece.
- You'll be told how to breathe in and out through the mouthpiece.
- Air pressure changes inside the room will show how much air your lungs can hold and how much air stays in your lungs after you breath out.
A lung volume test may be done by breathing a special mixture of gases for a few minutes while wearing a clip on your nose. For this test, you do not need to sit in an airtight room.
For a gas diffusion test:
- You'll sit on a chair with a soft clip on your nose. The clip makes sure you breathe only through your mouth.
- You'll place your lips tightly around a mouthpiece that's connected to a spirometer.
- You will be asked to breathe in a very small, safe amount of carbon monoxide gas. Then you'll hold your breath for about 10 seconds.
- Next, you'll breathe out through the mouthpiece. The spirometer will measure the amount of carbon dioxide you exhale. This shows how much of the gas your lungs were able to absorb and move into your blood.
For exercise tests:
Six minute walk test:
- Your blood pressure will be measured, and you'll be asked to rate any shortness of breath and fatigue that you feel.
- You'll walk as far as possible in six minutes, usually in a hallway.
- Your heart rate and the amount of oxygen in your blood will be checked as you walk.
- After six minutes, your blood pressure will be measured again, and you'll rate your shortness of breath and fatigue.
- If you normally use portable oxygen for a lung condition, you'll be able to use it during this test.
Cardiopulmonary exercise test (CPET):
- You'll be attached to monitors and machines that will measure your breathing, heart rate, blood pressure, and blood oxygen levels while you exercise.
- You'll breathe through a face mask or mouthpiece connected to a monitor. It measures how much oxygen you breath in and how much carbon dioxide you breath out.
- You'll exercise on a stationary bicycle or treadmill for a total of 10 to 20 minutes:
  You'll begin exercising with the bike or treadmill set to the easiest level.
  You'll slowly increase your effort until you feel you can't continue. On a bicycle, the resistance will increase, so it's harder to pedal. On a treadmill, the speed will increase, and the platform may tilt so you feel like you're walking uphill.
  As you exercise, you'll be asked to rate how you're feeling. If you have serious symptoms, the test will stop.
  The bike or treadmill will return to the easiest level while you keep pedaling or walking to cool down.
Your provider will let you know how to prepare for your lung function test. To make sure your test results are accurate, follow the instructions you're give. In general:
- Wear loose, comfortable clothing.
- Don't eat a large meal within at least two hours of the test.
- You may need to avoid certain activities or foods and beverages before your test. Your provider will tell you for how long. These include:
  Heavy exercise
  Smoking
  Drinking alcohol
  Drinking or eating products with caffeine, such as coffee, colas, and chocolate
- If you use inhaler medicines (bronchodilators), you may need to stop for a period of time before testing. Your provider will tell you when to stop. But never stop taking any medicine without talking with your provider first.
- If you wear dentures, wear them for the test. They'll help you close your lips tightly around the mouthpiece.
A normal lung function test result for you depends on the size of your lungs. Your lung size is based on your height, sex, and age. So, your provider will compare your test results to results from healthy people who are the same height, age, and sex as you.
If your results aren't normal, it may mean you have a lung condition. Lung function tests can't diagnose which specific lung disease you have. But your test results can tell which of the two main types you have:
- Obstructive lung conditions cause your airways to become narrow, making it hard for air to flow out of your lungs. Examples of obstructive lung diseases include asthma, bronchitis, and emphysema.
- Restrictive lung conditions decrease the amount of air your lungs can hold. This may happen if your lungs or your chest muscles can't expand fully when you breath in. Examples of restrictive lung conditions include scleroderma, sarcoidosis, pulmonary fibrosis, and interstitial lung diseases.
If you have questions about your results, talk with your provider.
1. https://medlineplus.gov/lab-tests/lung-function-tests/ [accessed on May 31, 2019]
2. https://medlineplus.gov/ency/article/003853.htm [accessed on May 31, 2019]
3. https://www.nhlbi.nih.gov/health-topics/pulmonary-function-tests [accessed on May 31, 2019]

Spirometry Test

Spirometry Test

Also called: Breathing Test, Lung Capacity, Pulmonary Function Testing

Spirometry is a pulmonary function test that is used to help diagnose and monitor chronic lung conditions such as asthma or COPD. During this test, you will make maximum breathing efforts several times, and a special machine called spirometer will be used to calculate and graph your results.

Spirometry Test

Also called: Breathing Test, Lung Capacity, Pulmonary Function Testing

Spirometry is a pulmonary function test that is used to help diagnose and monitor chronic lung conditions such as asthma or COPD. During this test, you will make maximum breathing efforts several times, and a special machine called spirometer will be used to calculate and graph your results.

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Use the slider below to see how your results affect your health.
Your result is Normal.
On a spirogram, the breath flow is usually shown on the X axis and expressed in liters per second, while the breath volume is shown on the Y axis and expressed in liters. A normal spirogram reveals a healthy curve that shows a jump right after the start of the expiration, then a steady and quick raise to a sharp peak, and finally a smooth and slow fall.
Related conditions
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Use the slider below to see how your results affect your health.
% predicted
80
Your result is Normal.
FEV values greater than 80% of the predicted average value are considered to be normal. Age and gender are the major factors that affect the average values of FEV in healthy individuals. Height, weight, and ethnicity are some of the other influencing factors.
Related conditions
{"label":"FEV1 reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"abnormal","label":{"short":"VSA","long":"Very severely abnormal","orientation":"horizontal"},"values":{"min":0,"max":35},"text":"A very severely abnormal FEV1 indicates a very severe airway obstruction, a lung condition that narrows your airways. This means that the air flows out of your lungs more slowly than it should (low FEV1) with less than 50% of the total amount in the first second. At this stage, quality of life is considerably impaired and disease exacerbations may be life-threatening.","conditions":["Alpha-1 antitrypsin deficiency","Asthma","Bronchiectasis","Bronchiolitis","COPD","Cystic fibrosis","Obstructive lung disease"]},{"flag":"abnormal","label":{"short":"SA","long":"Severely abnormal","orientation":"horizontal"},"values":{"min":35,"max":50},"text":"A severely abnormal FEV1 indicates a severe airway obstruction, a lung condition that narrows your airways. This means that the air flows out of your lungs more slowly than it should (low FEV1) with less than 50% of the total amount in the first second. At this stage, you may experience greater shortness of breath, reduced exercise capacity, and repeated exacerbations which have an impact on quality of life. ","conditions":["Alpha-1 antitrypsin deficiency","Asthma","Bronchiectasis","Bronchiolitis","COPD","Cystic fibrosis","Obstructive lung disease"]},{"flag":"abnormal","label":{"short":"MTSA","long":"Moderate to severely abnormal","orientation":"horizontal"},"values":{"min":50,"max":60},"text":"A moderate to severely abnormal FEV1 indicates a moderate to severe airway obstruction, a lung condition that narrows your airways. This means that the air flows out of your lungs more slowly than it should (low FEV1) with less than 60% of the total amount in the first second. At this stage, you may experience chronic respiratory symptoms or an exacerbation of the disease.","conditions":["Alpha-1 antitrypsin deficiency","Asthma","Bronchiectasis","Bronchiolitis","COPD","Cystic fibrosis","Obstructive lung disease"]},{"flag":"borderline","label":{"short":"MA","long":"Moderately abnormal","orientation":"horizontal"},"values":{"min":60,"max":70},"text":"A moderately abnormal FEV1 indicates a moderate airway obstruction, a lung condition that narrows your airways. This means that the air flows out of your lungs more slowly than it should (low FEV1) with less than 70% of the total amount in the first second. At this stage, you may experience chronic respiratory symptoms or an exacerbation of the disease.","conditions":["Alpha-1 antitrypsin deficiency","Asthma","Bronchiectasis","Bronchiolitis","COPD","Cystic fibrosis","Obstructive lung disease"]},{"flag":"borderline","label":{"short":"MA","long":"Mildly abnormal","orientation":"horizontal"},"values":{"min":70,"max":80},"text":"A mildly abnormal FEV1 indicates a mild airway obstruction, a lung condition that narrows your airways. This means that the air flows out of your lungs more slowly than it should (low FEV1) with less than 80% of the total amount in the first second. At this stage, you may not be aware that your lung function is abnormal. ","conditions":["Alpha-1 antitrypsin deficiency","Asthma","Bronchiectasis","Bronchiolitis","COPD","Cystic fibrosis","Obstructive lung disease"]},{"flag":"normal","label":{"short":"N","long":"Normal","orientation":"horizontal"},"values":{"min":80,"max":100},"text":"A normal FEV1 indicates the absence of airway obstruction. The normal range is calculated by the spirometer based on your height, age, sex and ethnicity. If your lungs and airways are healthy, you can blow out most of your breath in the first second. This pattern tells your doctor that your spirometry test is normal when compared to the expected results for you.","conditions":[]}],"units":[{"printSymbol":"% predicted","code":"%{predicted}","name":"percent predicted"}],"value":90,"disclaimer":"Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are \"within normal limits.\""}[{"abnormal":2},{"abnormal":1},{"abnormal":0},{"borderline":1},{"borderline":0},{"normal":0}]
Use the slider below to see how your results affect your health.
% predicted
35
50
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Your result is Normal.
A normal FEV1 indicates the absence of airway obstruction. The normal range is calculated by the spirometer based on your height, age, sex and ethnicity. If your lungs and airways are healthy, you can blow out most of your breath in the first second. This pattern tells your doctor that your spirometry test is normal when compared to the expected results for you.
Related conditions
{"label":"FEV1\/FVC ratio reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"abnormal","label":{"short":"S","long":"Severe","orientation":"horizontal"},"values":{"min":0,"max":50},"text":"A reduced FEV1\/FVC ratio means you can breath out less than 70% of the inhaled air in the lungs in one second. A low value indicates airflow limitation with an obstructive pattern.","conditions":["Alpha-1 antitrypsin deficiency","Asbestosis","Asthma","Bronchiectasis","Bronchiolitis","Bronchitis (chronic)","COPD","Cystic fibrosis","Emphysema","Epiglottitis (acute)","Lung cancer","Pulmonary fibrosis"]},{"flag":"abnormal","label":{"short":"M","long":"Moderate","orientation":"horizontal"},"values":{"min":50,"max":60},"text":"A reduced FEV1\/FVC ratio means you can breath out less than 70% of the inhaled air in the lungs in one second. A low value indicates airflow limitation with an obstructive pattern.","conditions":["Alpha-1 antitrypsin deficiency","Asbestosis","Asthma","Bronchiectasis","Bronchiolitis","Bronchitis (chronic)","COPD","Cystic fibrosis","Emphysema","Epiglottitis (acute)","Lung cancer","Pulmonary fibrosis"]},{"flag":"borderline","label":{"short":"M","long":"Mild","orientation":"horizontal"},"values":{"min":60,"max":70},"text":"A reduced FEV1\/FVC ratio means you can breath out less than 70% of the inhaled air in the lungs in one second. A low value indicates airflow limitation with an obstructive pattern.","conditions":["Alpha-1 antitrypsin deficiency","Asbestosis","Asthma","Bronchiectasis","Bronchiolitis","Bronchitis (chronic)","COPD","Cystic fibrosis","Emphysema","Epiglottitis (acute)","Lung cancer","Pulmonary fibrosis"]},{"flag":"normal","label":{"short":"N","long":"Normal","orientation":"horizontal"},"values":{"min":70,"max":100},"text":"A normal FEV1\/FVC ratio is 70% to 80% or higher in adults, 65% or higher in adults older than 65 and 85% or higher in children. In healthy people, a normal value indicates healthy lungs. In people with lung disease, a normal (or even elevated) value indicates restrictive disease.","conditions":[]}],"units":[{"printSymbol":"%","code":"%","name":"percent"}],"value":85,"disclaimer":"Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are \"within normal limits.\""}[{"abnormal":1},{"abnormal":0},{"borderline":0},{"normal":0}]
Use the slider below to see how your results affect your health.
%
50
60
70
Your result is Normal.
A normal FEV1/FVC ratio is 70% to 80% or higher in adults, 65% or higher in adults older than 65 and 85% or higher in children. In healthy people, a normal value indicates healthy lungs. In people with lung disease, a normal (or even elevated) value indicates restrictive disease.
Related conditions
Your doctor may want to order this test to help diagnose and monitor chronic lung conditions, such as:
- Asthma
- Chronic obstructive pulmonary disease (COPD)
- Restrictive lung disease, such as pulmonary fibrosis
- Cystic fibrosis
- Other disorders affecting lung function
Spirometry let doctors diagnose lung diseases at early stages when treatment is most effective. Then, routine spirometry tests can help monitor treatment effectiveness by assessing changes in lung functions.
Spirometry results indicate whether your lungs are functioning normally. It does this through several breathing measurements:
- Forced vital capacity (FVC): this is the total air volume that you can force out of your lungs after you take your biggest breath in.
- Forced expiratory volume in one second (FEV1): this is the amount of air that you can blow out of your lungs within the first second. It indicates whether or not there is airway obstruction.
- FEV1/FVC ratio: this is the percentage of the FVC exhaled in the first second.
Normal results vary from person to person depending on their gender, age, height, and race.
Abnormal spirometry results could be due to either restrictive lung disease (such as pulmonary fibrosis or sarcoidosis), obstructive lung disease (such as asthma or COPD), or a combination of both restrictive and obstructive lung disease.
Your doctor will take into consideration all spirometry measurements, along with the results of other tests, and your clinical findings to determine which type of lung disease is present.
1. Pulmonary Function Tests | National Heart, Lung, and Blood Institute (NHLBI) [accessed on Dec 09, 2018]
2. https://www.cdc.gov/nchs/data/nhanes/nhanes_11_12/spirometry_procedures_manual.pdf [accessed on Dec 09, 2018]
3. Spirometry and Bronchodilator Test [accessed on Dec 09, 2018]
4. Spirometry | the lung association [accessed on Dec 09, 2018]
5. Spirometry Testing | Breathing Test | Lung Capacity [accessed on Dec 09, 2018]
6. Spirometry: Procedure, Normal Values, and Test Results [accessed on Dec 09, 2018]
7. https://www.racgp.org.au/download/documents/AFP/2011/April/201104paraskeva.pdf [accessed on Dec 09, 2018]
8. https://cnx.org/contents/bbaedbf4-4d78-4b7c-bc94-2a742f0f2f8c [accessed on Dec 09, 2018]
9. https://covid19.nih.gov/news-and-stories/monitoring-lung-function [accessed on Sep 03, 2021]

Additional Materials (14)

An illustration depicting an incentive spirometer.

An illustration depicting an incentive spirometer.

Image by BruceBlaus

A medical illustration depicting spirometry

A medical illustration depicting spirometry

Image by BruceBlaus

Testing and Diagnosis

Your doctor will first take your medical history and ask you about your symptoms. He or she will probably listen to your lungs using a stethoscope, although there may be no abnormal chest sounds between asthma attacks. Your doctor may ask about any patterns relating to your symptoms: are they worse during allergy seasons, at work or at home, during exercise? Do you have a family history of asthma?

Image by TheVisualMD

Testing and Diagnosis

Your doctor will first take your medical history and ask you about your symptoms. He or she will probably listen to your lungs using a stethoscope, although there may be no abnormal chest sounds between asthma attacks. Your doctor may ask about any patterns relating to your symptoms: are they worse during allergy seasons, at work or at home, during exercise? Do you have a family history of asthma?

Image by TheVisualMD

Testing and Diagnosis of Asthma

Testing and Diagnosis of Asthma

Image by TheVisualMD

Airway during asthma symptoms

Figure A shows the location of the lungs and airways in the body. Figure B shows a cross-section of a normal airway. Figure C shows a cross-section of an airway during asthma symptoms.

Image by National Heart, Lung, Blood Institute

How Is the Cause of Cough Diagnosed?

The image shows how spirometry is done. The patient takes a deep breath and blows as hard as possible into a tube connected to a spirometer. The spirometer measures the amount of air breathed out. It also measures how fast the air was blown out.

Image by National Heart Lung and Blood Institute (NIH)

Asthma before-after

During an asthma episode, inflamed airways react to environmental triggers such as smoke, dust, or pollen. The airways narrow and produce excess mucus, making it difficult to breathe.

Image by FDA/Renée Gordon; vectors by Mysid

How Is COPD Diagnosed?

Doing a spirometry

Image by Jmarchn

Asthma in Children

A child using a peak expiratory flow meter in a pediatric clinic.

Image by National Heart, Lung and Blood Institute, a division of the National Institute of Health

Types of Lung Function Tests

A man undergoing whole body plethysmography

Image by Finchbook01 (talk)

Asthma Attacks

Constriction of the bronchioles and excess mucous production during an asthma attack.

Image by 7mike5000

Gas Exchange across Respiratory Surfaces

The partial pressures of oxygen and carbon dioxide change as blood moves through the body.

Image by CNX Openstax

Spirometry: how to take a lung function test

Video by The European Lung Foundation/YouTube

An illustration depicting an incentive spirometer.

BruceBlaus

A medical illustration depicting spirometry

BruceBlaus

Testing and Diagnosis

TheVisualMD

Testing and Diagnosis

TheVisualMD

Testing and Diagnosis of Asthma

TheVisualMD

Airway during asthma symptoms

National Heart, Lung, Blood Institute

How Is the Cause of Cough Diagnosed?

National Heart Lung and Blood Institute (NIH)

Asthma before-after

FDA/Renée Gordon; vectors by Mysid

How Is COPD Diagnosed?

Jmarchn

Asthma in Children

National Heart, Lung and Blood Institute, a division of the National Institute of Health

Types of Lung Function Tests

Finchbook01 (talk)

Asthma Attacks

7mike5000

Gas Exchange across Respiratory Surfaces

CNX Openstax

4:00

Spirometry: how to take a lung function test

The European Lung Foundation/YouTube

Lung Diffusion Testing

Lung Diffusion Testing

Also called: Gas Diffusion Study, Diffusing Capacity of the Lung for Carbon Monoxide, DLCO

A lung diffusion test is a painless and risk-free procedure in which you will be required to inhale a small amount of carbon monoxide that will be compared with the amount of the same carbon monoxide you exhale. This is useful to assess how well your lungs are functioning.

Lung Diffusion Testing

Also called: Gas Diffusion Study, Diffusing Capacity of the Lung for Carbon Monoxide, DLCO

A lung diffusion test is a painless and risk-free procedure in which you will be required to inhale a small amount of carbon monoxide that will be compared with the amount of the same carbon monoxide you exhale. This is useful to assess how well your lungs are functioning.

{"label":"Lung diffusion capacity reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"abnormal","label":{"short":"S","long":"Severe","orientation":"horizontal"},"values":{"min":0,"max":40},"text":"Low DLCO means your lungs aren\u2019t getting oxygen from the air to your blood efficiently. This might be because of issues in your heart or your lungs. For example, your heart might not be pumping well enough or your blood isn\u2019t able to effectively pick up oxygen.","conditions":["Airway blockage","Asthma","COPD with emphysema","Cystic fibrosis","Interstitial lung diseases","Lung tissue loss","Pulmonary embolism","Pulmonary fibrosis","Pulmonary hypertension","Sarcoidosis"]},{"flag":"abnormal","label":{"short":"M","long":"Moderate","orientation":"horizontal"},"values":{"min":40,"max":60},"text":"Low DLCO means your lungs aren\u2019t getting oxygen from the air to your blood efficiently. This might be because of issues in your heart or your lungs. For example, your heart might not be pumping well enough or your blood isn\u2019t able to effectively pick up oxygen. ","conditions":["Airway blockage","Asthma","COPD with emphysema","Cystic fibrosis","Interstitial lung diseases","Lung tissue loss","Pulmonary embolism","Pulmonary fibrosis","Pulmonary hypertension","Sarcoidosis"]},{"flag":"borderline","label":{"short":"M","long":"Mild","orientation":"horizontal"},"values":{"min":60,"max":75},"text":"Low DLCO means your lungs aren\u2019t getting oxygen from the air to your blood efficiently. This might be because of issues in your heart or your lungs. For example, your heart might not be pumping well enough or your blood isn\u2019t able to effectively pick up oxygen. Smoking can also cause a decrease in DLCO.","conditions":["Anemia","Post-exercise","Smoking"]},{"flag":"normal","label":{"short":"N","long":"Normal","orientation":"horizontal"},"values":{"min":75,"max":140},"text":"A normal DLCO indicates a normal lung function. DLCO is a calculated, derived value that indirectly assesses the ability of the lungs to \"transfer\" oxygen to blood through the use of a test gas (namely, CO) that has a greater affinity for blood hemoglobin. A normal result does not completely rule out lung disease.","conditions":[]},{"flag":"abnormal","label":{"short":"H","long":"High","orientation":"horizontal"},"values":{"min":140,"max":200},"text":"Increased DLCO can be caused by exercise or pregnancy. High DLCO is seen in conditions like obesity, asthma, which are characterized by large lung volumes.","conditions":["Asthma","Atrial septal defect","Bleeding in the lungs","Cardiac shunt","Chronic bronchitis","Exercise","Heart failure","High altitude","Obesity","Polycythemia vera","Pregnancy"]}],"units":[{"printSymbol":"%","code":"%","name":"percent"}],"value":107.5,"disclaimer":"Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are \"within normal limits.\""}[{"abnormal":1},{"abnormal":0},{"borderline":0},{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your health.
%
40
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75
140
Your result is Normal.
A normal DLCO indicates a normal lung function. DLCO is a calculated, derived value that indirectly assesses the ability of the lungs to "transfer" oxygen to blood through the use of a test gas (namely, CO) that has a greater affinity for blood hemoglobin. A normal result does not completely rule out lung disease.
Related conditions
Your doctor may want to order this test to help diagnose and monitor chronic lung conditions, such as:
- Asthma
- Chronic obstructive pulmonary disease (COPD)
- Restrictive lung disease, such as pulmonary fibrosis
- Cystic fibrosis
- Other disorders affecting lung function
Normal results vary depending on the person’s age, sex, height, ethnicity, and health status.
Normal
If there’s significantly less exhaled carbon monoxide in your breath when compared with the amount of carbon monoxide that you inhaled, then this means that your lung function is normal because the gas was successfully absorbed into your bloodstream.
Abnormal
If the amount of inhaled and exhaled carbon monoxide in your breath is similar, it means that there is a problem in your lungs that is preventing the gas from being absorbed adequately. This can happen due to:
- Asthma
- Emphysema
- Cystic fibrosis
- Pulmonary fibrosis
- Sarcoidosis (a chronic disease characterized by the development of small tumors throughout the body)
- Airway blockage by a foreign body
- Pulmonary hypertension (high blood pressure in the lungs)
- Lung tissue loss
- Pulmonary embolism
1. https://medlineplus.gov/ency/article/003854.htm [accessed on Feb 03, 2019]
2. https://my.clevelandclinic.org/health/diagnostics/15445-gas-diffusion-study [accessed on Feb 03, 2019]
3. https://www.healthline.com/health/lung-diffusion-testing [accessed on Mar 20, 2019]
4. https://www.verywellhealth.com/lung-diffusion-tests-914897 [accessed on Mar 20, 2019]
5. https://www.nationaljewish.org/treatment-programs/tests-procedures/pulmonary-physiology/pulmonary-function/lung-diffusion-capacity [accessed on Mar 20, 2019]
6. https://www.uclahealth.org/lungcancer/lung-diffusion [accessed on Mar 20, 2019]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Stress Tests

Stress Tests

Also called: Cardiac Stress Test, Cardiac Diagnostic Test

Stress tests shows how well your heart works when it's pumping hard. They can find problems with blood flow to your heart muscle and other heart conditions. Reduced blood flow can be a sign of a serious heart disease.

Stress Tests

Also called: Cardiac Stress Test, Cardiac Diagnostic Test

Stress tests shows how well your heart works when it's pumping hard. They can find problems with blood flow to your heart muscle and other heart conditions. Reduced blood flow can be a sign of a serious heart disease.

Stress tests show how well your heart works when it's pumping hard. Some heart diseases are easier to find when your heart is working its hardest to pump blood through your body. So stress tests check your heart while you exercise on a treadmill or stationary bicycle. If you're not able to exercise, medicine can be used to make your heart work harder , as if you were exercising.
There are different types of stress tests. They all check:
- Blood flow in your heart
- Your blood pressure
- The rate and rhythm of your heartbeat
- The strength of the electrical signals that control your heartbeat
Some stress tests also take pictures of your heart at rest and when it's working hard. The pictures provide more detail about how your heart is working.
Stress tests are most often used to find the cause of symptoms that may be from a heart problem.
The tests can help diagnose certain heart conditions, including:
- Coronary artery disease (CAD)
- Angina
- Arrhythmia
- Heart failure
- Heart valve diseases
- Cardiomyopathy
Stress testing is also used:
- To find out how serious a known heart condition is, including the chance that you'll have a heart attack in the future.
- To help make treatment decisions for a heart condition.
You may need a stress test if you have symptoms that could be from a heart condition. Symptoms may include:
- Chest pain or discomfort without a known cause
- Shortness of breath
- Irregular or rapid heartbeat that may feel like a fluttering in your chest
- Feeling dizzy or lightheaded
You may also need a stress test to check your heart health if you:
- Have a heart condition with new or worsening symptoms.
- Are going to have surgery. Your health care provider may want to see if your heart is strong enough for the operation.
- Are being treated for heart disease. The test can show how much treatment is helping, including heart surgery.
- Have a high risk for heart disease. Your risk may be higher than normal if you have a family history of heart disease and/or certain conditions, such as diabetes, that are linked to heart disease.
- Plan to start an exercise program. If you have a heart condition or a high risk for a heart condition, a stress test can show what level of exercise is safe for you. (Always talk with your provider before starting any strenuous, new exercise.)
Stress tests may be done with or without imaging (pictures of your heart). The most common type of test is an exercise stress test. It doesn't include pictures. But the main steps of an exercise stress test are part of all stress tests:
- You'll have a blood pressure cuff on your arm to check your blood pressure.
- Electrodes will be placed on your body for an electrocardiogram test (also called EKG or ECG). Electrodes are small sensors that stick to your skin. Wires connect the electrodes to a computer or an EKG machine that records the electrical activity in your heart during the stress test.
- If you're unable to exercise: An intravenous (IV) line will be inserted into a vein in your arm. You'll get medicine through the IV. The medicine will make your heart work harder for 10 to 20 minutes while an EKG records your heart's electrical activity. Medicine can be used instead of exercise for all types of stress tests.
- If you can exercise: You'll walk on a treadmill or ride a stationary bicycle. On a treadmill, the speed will slowly increase. The treadmill may also tilt so you feel like you're walking uphill. On a bicycle, the resistance will slowly increase, so it's harder to pedal.
  You'll exercise for about 10 to 15 minutes until you reach a target heart rate based on your age and fitness level. But you may stop the test sooner if:
  
  You develop chest pain, shortness of breath, dizziness, fatigue or other symptoms
  The EKG shows a problem with your heart
- After all types of stress tests, you'll be monitored for 10-15 minutes or until your heart rate returns to normal.
Stress tests with pictures include stress echocardiograms, nuclear stress tests, and cardiac (heart) MRI stress tests. These tests have extra steps:
A stress echocardiogram or "echo" takes moving pictures of your heart using doppler ultrasound. The pictures show the size and shape of your heart and blood flow through your heart. Pictures will be taken before and after your heart has worked its hardest. You'll lie on your left side on a table as a provider moves an ultrasound device on your chest. If you exercise on a bicycle, the second set of pictures may be taken while you're pedaling.
A nuclear stress test takes pictures of your heart using a small amount of a radioactive substance called a "tracer" and a special camera that scans your heart. A provider injects the tracer into your bloodstream through an IV line that's placed in a vein. Your heart and blood vessels absorb the tracer, which makes them show up more clearly in the pictures.
Pictures are taken while you lie on a table before and after your heart has worked its hardest. After the test, the tracer naturally leaves your body in your urine (pee). Drinking lots of water will help remove it faster.
A cardiac MRI stress test takes the most detailed pictures of your heart using radio waves, magnets, and a computer. It is a newer test that's mostly used for very serious heart problems. For an MRI stress test:
- A provider may inject dye into your bloodstream through an IV line placed in your arm. Some cardiac MRIs, but not all, use dye to help show very small details on the pictures.
- Pictures of your heart may be taken before and after your heart has worked hard. To take the pictures, you'll lie on a table that slides into a large, tunnel-like MRI machine. You'll hear loud sounds as the machine takes pictures. If you're exercising for the test, you may use a treadmill near the MRI, or you may exercise while lying in the MRI machine using special devices to move your arms or legs.
1. Stress Tests: MedlinePlus Medical Test [accessed on Mar 09, 2023]

Exercise Tolerance Test

Exercise Tolerance Test

Also called: Treadmill Stress Testing, Exercise Stress Test, Cardiopulmonary Exercise Test, CPX Test

Exercise tolerance testing is a form of cardiac stress testing that uses treadmill exercise with electrocardiogram (EKG) and blood pressure monitoring. The test is used to determine a patient’s functional capacity, assess the probability and extent of coronary artery disease (CAD) as well as assess risks, prognosis and effects of therapy.

Exercise Tolerance Test

Also called: Treadmill Stress Testing, Exercise Stress Test, Cardiopulmonary Exercise Test, CPX Test

Exercise tolerance testing is a form of cardiac stress testing that uses treadmill exercise with electrocardiogram (EKG) and blood pressure monitoring. The test is used to determine a patient’s functional capacity, assess the probability and extent of coronary artery disease (CAD) as well as assess risks, prognosis and effects of therapy.

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Use the slider below to see how your results affect your health.
(mL/kg)/min
30
Your result is Good.
VO2 max refers to the maximum amount of oxygen that an individual can utilize during intense or maximal exercise. The greater your VO2 max, the more oxygen your body can consume and transport to your organs, muscles, and tissues, enabling you to have better endurance and performance for a given effort.
Related conditions
- Before the test begins, your nurse or doctor will explain it to you. Feel free to ask questions and voice concerns at this time. When you understand what will happen, you will be asked to sign a consent for the test to be performed.
- To monitor your heart during exercise, adhesive patches, called electrodes, will be put on your chest. Your chest will be cleansed with alcohol and shaved in some areas (if necessary) before these electrodes are placed.
- You will be asked about symptoms you have had with exercise in the past. Describe, as completely as you can, any chest discomfort, breathing problems, lightheadedness or dizziness, fluttering in the chest, weakness, fatigue, or anything else you think may be relevant. Also, mention anything you feel while you are being prepared for the test.
- A nurse or doctor will be with you throughout the test. Your heart rate and rhythm and your blood pressure will be checked during the test.
- Generally, the treadmill’s pace and incline will increase every 3 minutes. It is important that you describe anything you feel as you exercise. If you become short of breath, the nurse may ask you to rate it as “mild,” “moderate,” or “severe.” If you have chest discomfort, you will be asked to describe it as best you can and rate it on a scale of 1 to 10 (1 is very mild; 10 is very severe). There is no right or wrong number. This helps your doctor know how you are doing and gives us a better way to compare how you feel before and after the test.
- Keep walking until you are told to stop or until you cannot walk any longer. Let the nurse know when you need to slow down. Keep walk-ing as the treadmill slows. Do not jump off.
- While you rest, your heart will continue to be monitored.
- Inform the doctor or nurse about any temporary or permanent condition that could affect your ability to move, walk, bear weight, or keep your balance. If possible, discuss this when you are first scheduled for the test. It is also important that the doctor and/or nurse conducting the test have this information.
- Carefully follow your doctor’s instructions about medications. Some medications should be stopped for 48 hours before the test; others should not be stopped. If you do not have clear instructions about all your medications (including those for your heart, blood pressure, or other medications), contact your doctor or nurse a few days before the test.
- Avoid caffeine, alcohol, and nicotine 8 hours before the test. Do not eat 2 hours before the test, and do not drink liquids 1 hour before the test. If your exercise test is combined with heart imaging (such as a thallium scan), follow the specific instructions for that test.
- Try to be as well rested as possible. You may need to reschedule the test if you feel unwell (for example, if you have a cold). If you do not feel you can give your maximum exercise effort, contact your nurse or doctor before the test.
- Wear loose, comfortable clothing with a separate top and bottom. Women should wear bras. Wear comfortable, flat shoes that will not slip off while you are walking.
After the procedure:
- You can eat and drink as usual.
- Depending on how you feel, you may go about your normal routine or take it easy if the test tired you.
- Do not take a hot shower for at least an hour after the test. Your blood vessels expand with exercise and need time to return to normal. A hot shower may expand them more, causing low blood pressure and dizziness.
1. Procedures/Diagnostic Tests. Exercise tolerance test. National Institutes of Health Clinical Center. [accessed on Dec 11, 2018]
2. Vilcant V, Zeltser R. Treadmill Stress Testing. [Updated 2018 Oct 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. [accessed on Dec 11, 2018]
3. Am Fam Physician. 2017 Sep 1;96(5):293-299. Exercise Stress Testing: Indications and Common Questions. Garner KK, Pomeroy W, Arnold JJ. [accessed on Dec 11, 2018]
4. Am Fam Physician. 1999 Jan 15;59(2):401-10. Ordering and understanding the exercise stress test. Darrow MD. [accessed on Dec 11, 2018]
5. Harvard Men's Health. Cardiac exercise stress testing: What it can and cannot tell you. [accessed on Dec 11, 2018]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Stress Echocardiography

Stress Echocardiography

Also called: Echocardiography Stress Test, Stress Echo

Stress echocardiography, or echo, is a test that uses sound waves to create moving pictures of your heart. A stress echo is done as part of a stress test. Some heart problems, such as coronary heart disease, are easier to diagnose when the heart is working hard and beating fast.

Stress Echocardiography

Also called: Echocardiography Stress Test, Stress Echo

Stress echocardiography, or echo, is a test that uses sound waves to create moving pictures of your heart. A stress echo is done as part of a stress test. Some heart problems, such as coronary heart disease, are easier to diagnose when the heart is working hard and beating fast.

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Use the slider below to see how your results affect your health.
Your result is Normal.
A normal result means that blood flow through the coronary arteries is probably normal.
Related conditions
1. https://medlineplus.gov/ency/article/007150.htm [accessed on Feb 23, 2022]
2. https://medlineplus.gov/lab-tests/stress-tests/ [accessed on Feb 23, 2022]
3. https://www.nhlbi.nih.gov/health-topics/echocardiography [accessed on Feb 23, 2022]

Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."

Treatment

Bronchodilator

Image by BruceBlaus

Bronchodilator

Patient using bronchodilator

Image by BruceBlaus

What Are the Treatments for Emphysema?

There is no cure for emphysema. However, treatments can help with symptoms, slow the progress of the disease, and improve your ability to stay active. There are also treatments to prevent or treat complications of the disease. Treatments include

Lifestyle changes, such as
- Quitting smoking if you are a smoker. This is the most important step you can take to treat emphysema.
- Avoiding secondhand smoke and places where you might breathe in other lung irritants
- Ask your health care provider for an eating plan that will meet your nutritional needs. Also ask about how much physical activity you can do. Physical activity can strengthen the muscles that help you breathe and improve your overall wellness.
Medicines, such as
- Bronchodilators, which relax the muscles around your airways. This helps open your airways and makes breathing easier. Most bronchodilators are taken through an inhaler. In more severe cases, the inhaler may also contain steroids to reduce inflammation.
- Vaccines for the flu and pneumococcal pneumonia, since people with emphysema are at higher risk for serious problems from these diseases
- Antibiotics if you get a bacterial or viral lung infection
Oxygen therapy, if you have severe emphysema and low levels of oxygen in your blood. Oxygen therapy can help you breathe better. You may need extra oxygen all the time or only at certain times.
Pulmonary rehabilitation, which is a program that helps improve the well-being of people who have chronic breathing problems. It may include
- An exercise program
- Disease management training
- Nutritional counseling
- Psychological counseling
Surgery, usually as a last resort for people who have severe symptoms that have not gotten better with medicines. There are surgeries to
- Remove damaged lung tissue
- Remove large air spaces (bullae) that can form when air sacs are destroyed. The bullae can interfere with breathing.
- Do a lung transplant. This is might be an option if you have very severe emphysema.

If you have emphysema, it's important to know when and where to get help for your symptoms. You should get emergency care if you have severe symptoms, such as trouble catching your breath or talking. Call your health care provider if your symptoms are getting worse or if you have signs of an infection, such as a fever.

Source: National Heart, Lung, and Blood Institute (NHLBI)

Additional Materials (1)

Emphysema Treatment

Video by Armando Hasudungan/YouTube

5:59

Emphysema Treatment

Armando Hasudungan/YouTube

Prevention

Stop Smoking and drinking

Image by TheVisualMD

Stop Smoking and drinking

Stop Smoking and drinking

Image by TheVisualMD

Can Emphysema Be Prevented?

Since smoking causes most cases of emphysema, the best way to prevent it is to not smoke. It's also important to try to avoid lung irritants such as secondhand smoke, air pollution, chemical fumes, and dusts.

Source: National Heart, Lung, and Blood Institute (NHLBI)

Additional Materials (1)

Emphysema - Pathophysiology (COPD)

Video by Armando Hasudungan/YouTube

9:48

Emphysema - Pathophysiology (COPD)

Armando Hasudungan/YouTube

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Emphysema

Emphysema is a type of COPD involving damage to the air sacs (alveoli) in the lungs. Emphysema makes it hard to catch your breath. The most common cause of emphysema is smoking. Learn about symptoms and treatment.

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