Air pollution may also hasten the development of this disease. In the beginning stages, a person with emphysema often suffers very bad colds each winter for a few years, each accompanied by a heavy cough and perhaps chronic bronchitis. The cough frequently persists and becomes chronic. As the disease progresses, slight morning and evening breathing difficulties may worsen until breath-lessness interferes with daily life. Eventually, as the lungs become less and less able to inhale, exhale, and exchange gases, there may come a point when every breath is a major effort and normal activities become impossible.
Shortness of breath is the symptom that most commonly prompts a person to seek medical attention.
The patient may mistake the problem for asthma or heart disease. In fact, emphysema may lead to serious cardiovascular problems. Because the disease interferes with the passage of blood through the lungs and into the circulation, the heart must work harder. It may enlarge and eventually suffer heart failure. Diagnosing emphysema entails a physical exam, medical history, laboratory tests that measure oxygen and carbon dioxide levels in the blood, and pulmonary function tests that measure lung volumes and airflow rates.