Pulmonary Hyperinflation (Emphysema): Symptoms, Complaints, Signs

The following symptoms and complaints may indicate emphysema (pulmonary hyperinflation):

  • Dyspnea (shortness of breath) – increases as the disease progresses.
  • Fassthorax (shape of chest resembles a barrel) with:
    • Distended clavicle pits
    • ribs running horizontally
    • Inspiratory (“when breathing in”) retractions in the flank area.
  • Small respiratory volumes
  • Polyglobulia – excessive increase in the number of erythrocytes (red blood cells) in the blood.
  • Irritative cough
  • Drumstick finger
  • Clock glass nails (arched nails)
  • Central cyanosis – bluish discoloration of skin and central mucous membranes / tongue.

In chronic obstructive pulmonary disease (COPD), two types of emphysema (phenotypes/appearances) are distinguished

Blue Bloater Pink Buffer
Habitus (weight) Overweight slim to cachectic
Skin coloration Cyanotic (bluish discoloration of the skin or mucous membranes) Pale

Clinical symptoms Suffers little dyspnea (shortness of breath), but productive cough Severe dyspnea and dry irritating cough
Physical examination (auscultation/listening). Wet rales (wet RGs),

expiratory wheezing (some distance wheezing).

Quiet breath sounds; silent chest (silent lung phenomenon).

Blood gas analysis (ABG) Early respiratory global insufficiency (oxygen partial pressure: pO2 ↓ , carbon dioxide partial pressure: pCO2 ↑). Respiratory partial insufficiency (pO2 ↓, pCO2 normal or ↓).

Complications
(see also under secondary diseases)

  • Chronic hypoxia (reduced supply of oxygen to the body) with secondary polyglobulia (increase in the number of red blood cells), drumstick fingers (TSF), and clock glass nails (roundish in shape and strongly curved outward)
  • Early cor pulmonale (“pulmonary heart“).
  • pulmonary cachexia
  • Late cor pulmonale