Emphysema happens when the air sacs in the lungs become damaged. The air sacs, called alveoli, inflate and deflate as you breathe, exchanging the oxygen in the lungs. When the alveoli are damaged, it is difficult to breathe.

Overview and Symptoms

The most common cause of emphysema is smoking. Quitting smoking before emphysema develops can help to prevent it; quitting after emphysema has been diagnosed can help keep it from getting worse.

Symptoms include:

  • A chronic cough with mucus
  • Shortness of breath and breathlessness
  • Chest tightness and wheezing
COPD can be diagnosed in many ways.

  • Spirometry, a painless procedure during which you blow into a tube to measure how much air your lungs can hold, and how long it takes to breathe out.
  • Blood tests can help determine if the lungs are working properly.
  • Chest X-rays or CT scans allow doctors to examine detailed images of your lungs.
  • Additional tests may include an echocardiogram (which is an ultrasound test to check heart structure and function); cardiopulmonary exercise testing (a test on a bike or treadmill which can check how well the heart and lungs work together); or a sleep study (to check for COPD-related sleep disturbances).


BIDMC is the first hospital in Boston to offer two new minimally invasive procedures — endoscopic lung volume reduction coils and endobronchial valves — that do not require a major operation and hold great promise for patients with severe emphysema. These devices may make it easier to breathe, exercise and enjoy everyday life for patients who are not responding to medicine, or who are too sick or prefer not to undergo surgery. Doctors in the COPD Clinic can determine if you may be a candidate for one of these endoscopic procedures.

  • Lung Volume Reduction Coils - These coils can help you breathe easier. Using a bronchoscope (a thin, flexible tube inserted through the mouth or nose under light anesthesia), a doctor can place coils (tiny, flexible spirals) in the airways of the lung.

The coils catch, gather, and reduce the size of the diseased and over-inflated lung tissue. Healthier lung tissue can then expand and function more normally.

  • Endobronchial Valves - Under anesthesia, using a bronchoscope inserted through the mouth, doctors place small, umbrella-shaped, one-way valves inside the airways that lead to the most diseased part of the lung.

The valve stops inflow and allows escape of the trapped air in the diseased tissue so the healthier areas of the lung can breathe easier.

By deflating the overblown portion of the lung, the valve helps reduce the volume (size) of the diseased and over-inflated lung. Healthier lung tissue can expand and function more normally.

Learn More

The Chest Disease Center combines a team of highly skilled specialists with state-of-the-art facilities to provide multidisciplinary evaluation, treatment and care to patients who have benign (non-cancerous) and malignant (cancerous) lung diseases.

Chest Disease Center