Emphysema Life Expectancy-Questions and Answers

Emphysema is a chronic and progressive lung disease is really due to respiratory symptoms such as shortness of breath and characterized, especially during physical exertion. It is truly one of the aspects of chronic obstructive pulmonary disease (COPD).

The patient may also manifest wheezing, chronic cough, tightness in the chest and weight reduction. Emphysema is brought as a result of a long-term exposure to toxic chemicals and dangerous fumes. In the majority of patients with smoking, the most common cause of emphysema can be extended.

Medical studies related to emphysema life expectancy have been completed in order to predict the survival rate of patients with this chronic lung disease. Much more on consequences of smoking.

What is emphysema?

In a patient with emphysema, the air sacs in the distal end of the bronchioles (small airways) is increased, and finally destroyed. This leads to decreased elasticity of lung tissue and the formation of irregular pockets of the spherical air sacs.

Since the amount of airbags will reduce the amount of inhaled air (oxygen), which enters the blood stream is also reduced. Also caused damage and reduced elasticity of forced expiration with the airbags. A total of emphysema patients may have difficulty in breathing. Much more on the breathing workouts for COPD.

Stages of emphysema and life expectancy

The incidence of emphysema is greater in older men who are over 65 years. Notable symptoms manifest when 30-50 percent of lung tissue damage. It is really appreciated that more than two million Americans suffer from this degenerative lung disease. According to the results of breathing tests (lung function tests, PFTs) are four stages of emphysema – Stage 1 (mild), level two (moderate), the third stage (severe) and stage four (very strong).

Used to estimate the life expectancy emphysema spirometry is the proportion of air that is in a second, FEV1 (forced expiratory volume over 1 second) is called to measure exhaled.

For a healthy person, the spirometer reading falls in between 80-100 percent. In the case of emphysema patients whose FEV1 values ​​below 35 percent, disease prognosis, suggesting that the final stage and the patients most likely to survive for about four years.

There is no doubt that the life expectancy of an individual with emphysema reduced. If a severe case is left untreated, can affect the life expectancy with emphysema than four years (as short as 2-3 years). But with all effective measures a patient can survive from emphysema for several years.

In addition to the diagnostic test results are also other aspects to be considered during the study emphysema prognosis. Such aspects are the patient’s weight (low weight is dangerous) to go in a certain period and also the degree of respiratory distress for the duration of the effort.

One patient in the terminal stage manifests severe breathing difficulties and a lack of activity tolerance. Several times prescribed, the improvement of the doctor long-term oxygen therapy for relief of breathing and the life expectancy of emphysema patients. Excess secretion of mucus and cough occurs really often.

The patient is at high risk of creating respiratory diseases such as pneumonia and acute bronchitis. Emphysema is compounded when accompanied with infectious diseases. This could be the reason why most of the emphysema patients with pneumonia and flu vaccine.

This was shortly in regard to life expectancy of emphysema patients. As per wellness experts, there is no permanent cure for emphysema. In other words, the loss of lung tissue can not be reversed or stopped. Powerful Emphysema Treatment includes in particular measures to slow the progression of the disease.

Basically the most important tip would be to quit smoking and prevent exposure to cigarette smoke and other lung irritants. Other therapeutic drugs administered to reduce inflammation, reduce infections and the relaxation of the bronchial tubes. To increase survival probability, one needs to follow the activity guidelines and a healthy diet plan proposals for the doctors.

Emphysema Life Expectancy – What You Can Do About It

This disease is provoked damage to the lungs and most doctors usually tell patients the severity of the problem. All patients will usually know about the life expectancy of emphysema. It helps compliance with doctor’s orders and dealing with the state as well.

Doctors usually with the study approach, with different stages of the disease stages. Emphysema life expectancy varies in each individual. It can, however, the prognosis under control and in most cases be kept. Knowing the exact stage and its dangers will contribute to coping, although each case is slightly different and individually, depending on the patient’s overall health.

It’s much easier to cope with the facts of life expectancy of emphysema, with the phases of its development have. Following the development of the disease usually helps prevention.

However, this is a very typical and unpredictable state. Virtually no one can say exactly what is emphysema life expectancy is independent of all types of information and the stage of the patient is in. But the knowledge about the stages a little security and the knowledge of how to keep you in control while in the early states .

Moreover, the fact is aware that nobody is able to predict, it helps a patient to get with the conditions. The knowledge of the stages and the development of the disease is a bit of hope for patients.

Emphysema life expectancy is closely related with the pulmonary function of patients, and related, it is a very common disease of all time. A prognosis and staging is necessary where the lungs of patients to be tested. Emphysema life expectancy is a concept that can not be adjusted to be accurate, but the use of tests for lung function largely helps in determining the diagnosis and prognosis as well. Such tests may be the doctors at what stage a patient’s lung.

This is the only way to determine the exact stage of the disease, which operate at least to define a general framework for the lung’s ability properly.

Emphysema life expectancy is substantially defined by carrying out the tests, which show lung capacity in a patient. PTF is a test of all the doctors, the only way to define the stage emphysema and knowledge about the life expectancy in a broader sense.

Simple test consists of injecting air into and out of the tube. The accurate measurement of air flow from person shows the exact stage of lung disease. This is still the only way you can be the forecast set at all

Emphysema Life Expectancy Stop smoking

Emphysema is a lung disease, and the tissue damage to the lungs. Patients with this disease have difficulty breathing, tightness in chest, severe cough and weight loss. This is a progressive disease that has no cure at the moment. This is because the damaged tissue in the lungs beyond repair. Emphysema life expectancy for each patient.

While there is no medicine that will cure emphysema, there are treatments available that help may be slow to control the spread of infections and the progression of the disease.

This may emphysema life expectancy longer. There are four stages of emphysema. Stage 1 is mild emphysema, moderate emphysema, the stage 2, stage 3 and stage 4 is very difficult to severe emphysema or terminal emphysema.

Stage 4 emphysema life expectancy is about four years. However, the patients put on treatment by the doctor on call and will remain away things that can aggravate his condition, such as smoking and exposure to toxic chemicals. If the disease is not treated at this level, the life expectancy of emphysema patients will be lower. Instead of four years, it is only about two minutes, three years ago. It is performed a test to know the stage of emphysema, a patient. This is called pulmonary function or PFT.

A test can also be used to estimate the life expectancy of the patient are made. It’s called spirometry. This test measures the volume of air exhaled per second.

The result gives the doctor an idea about the current state of the patient. A normal person without emphysema, a result between 80 and 100 The lower the result, the shorter the life expectancy.

Top Tips on Emphysema Life Expectancy and How it Can Be Improved

Emphysema is a continuous and progressive lung disease (lung) his problem and all his symptoms are associated with respiratory problems. if you suffer for the disease, you will know how short of breath, difficulty breathing issues and it might be awkward to get a sensation during exercise.

Production from the fact that health challenges are causing challenges in breathing, there is (can not breathe properly as you) too much carbon dioxide into the general body and too much carbon dioxide will cause health hazards.

While the symptoms of emphysema and bronchitis are quite similar continuous, emphysema, breathing difficulties is unique, and the reason for this is one of the prolonged expiration.

But the worst bit of information is that life expectancy could be pretty bad emphysema. But that might say, of course, depends on the length of one of the disease.The Stages Of EmphysemaStage one – this may be the previous period of emphysema.

The spirometer reading is between 70 and 80 and the possibility of recovery is extremely good.Stage two – Secondary period of emphysema. The spirometer reading somewhere is 60-70 and the possibility of recovery is fair.

Stage three – this might be the third period of emphysema. The spirometer reading is between 50 and 60, and recovery can be very hard here.Stage four – this may be the last period of emphysema.

The spirometer reading is between 35 and 40 and the possibility of recovery is extremely slim.As easily be understood from above, if the diagnosis is suffering in the early years, then a cure is definitely possible.

Nevertheless, these changes significantly deteriorated production from the fact that health challenges and passes for a remarkable stadiums. So it really is extremely important, as the symptoms are identified early and treated.

In other words, if it can be an incurable disease emphysema, but the emphysema life expectancy can be quite advantageous if rapid action is taken.Some people think that the life expectancy with emphysema can not much longer than five years and in many cases is much less than a year.

But the fact is, that’s really just a general statement, because if the health challenges identified and appropriate treatment initiated, then the individual can stay a little longer. But you really need, to prepare, to quit smoking immediately because smoking potentially be the biggest reason for an illness.

Take care to look at things, because emphysema may have an effect on you during pregnancy and symptoms of EmphysemaThe children.Understanding The most common symptoms of their own health challenges are problems with breathing, which can be called periodically as dyspnea. regularly the individual also suffers from coughing and wheezing.

There may be some sputum and with the cough. The general body appear azure blue in color when a person suffers for the other health challenges – a condition recognized as cyanosis. And there may be some excess mucus as well. in some cases the affected person may also improve overall body fat too much rapidly.

To emphysema life expectancy, physicians regularly prescribe long-term oxygen therapy, which also facilitates the breathing problems. Small, portable oxygen tanks can provide 24-hour supply of oxygen for oxygen-deficient patients with emphysema.

However, the patient must work for a doctor’s advice. regular medications are also prescribed. regular medication is not only for the removal of an infection that can be lungs.Some other means, the life expectancy of emphysema should be increased, a claim may help broncholiators, and it can reduce the lung surgery.

There are several choices remedies so effective that you could try. The challenges in health care affects humans and pets as your canine friend. You can enlighten your buddies and family, as the challenges in healthcare is not contagious, and ask them to help you.
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Emphysema Life Expectancy Stages

Emphysema occurs when air sacs in the lungs are destroyed gradually, so that you increasingly short of breath. Emphysema is one of several common diseases as chronic obstructive pulmonary disease (COPD) is known. Smoking is the main cause of emphysema.

As it deteriorates, the emphysema is spherical air sacs – clusters like grapes – in large, irregular pockets with gaping holes in their interior walls. This reduces the area of ​​the lungs and in turn the amount of oxygen that reaches the bloodstream.

Life expectancy emphysema Stages

The better part of the last decades involved in the exploration of the pathogenesis of emphysema animal experiments where various proteases were taught in the trachea of ​​various species of animals.

These animals developed connective tissue damage, which was in support of the protease-antiprotease theory taken. However, just because these substances can destroy connective tissue in the lungs, such as someone to be able to predict, does not establish causality. Recent experiments have more technologically advanced approaches such as those with genetic engineering focused.

A particular development in terms of our understanding of the disease involves the production of protease “knock-out” animals that are genetically deficient in one or more proteases, and to assess whether they are less susceptible to developing the disease.

Often people who are unfortunate enough to contract this disease have a very short life expectancy, often 0-3 years at most.

Emphysema Stages life expectancy to determine the life expectancy with emphysema, spirometry is performed.

This is actually the measure of the percentage of air that is exhaled in one second. This is called forced expiratory volume over 1 second or FEV1. Nearly 80% of stage I or mild emphysema patients have a mild emphysema life expectancy of more than 4 years. If an adult is completely healthy, then the reading of the spirometer is between 80 to 100 percent.

A person who has emphysema and who is shown on the spirometer readings below 35 percent, then the prognosis of the disease, the last period of emphysema and stage IV emphysema life expectancy, or in other words, which in the end-stage emphysema life expectancy about four years.

Only 50% of people with severe emphysema over four years to survive. However, if the stage 4 emphysema is diagnosed then the life expectancy is shortened by 2 to 3 years. In the last phase is suffering from extreme breathlessness, activity tolerance with no consistent cough with discharge of mucus.
Emphysema: stages and prognosis
GOLD emphysema staging is as follows:

Stage I, mild emphysema: FEV1 greater than or equal to 80% of normal.

Stage II, moderate emphysema: FEV1 of less than 80% but greater than or equal to 50% of normal.

Stage III, severe emphysema: FEV1 of less than 50% but greater than or equal to 30% of normal.

Stage IV, very severe emphysema: FEV1 of less than 30% of normal, or less than 50% of the normal low blood oxygen content.

Stop smoking. This is the most important measure that can take you to your overall health and the only one that the progression of emphysema could be stopped. Join a smoking cessation program if you need help to quit smoking. Passive smoking as much as possible, be avoided. Avoid other irritants.

These include fumes from paint and car exhaust fumes, cooking smells opportunity, certain perfumes, even burning candles and incense. Change furnace and air conditioner filters regularly to limit pollutants.

Emphysema life expectancy and treatment

To be honest about it, life expectancy is emphysema not very encouraging. This disease affects one person is progressive and irreversible, and therefore the life expectancy is quite affected because of emphysema.

Alternative treatments may offer some help. Not only people, attacks and emphysema animals. For example, canine emphysema is not uncommon.

Before antibiotics, causing infection in the lungs, primarily by the tubercle bacillus, the tuberculosis could not be cured – only the doctors described the problem as a “wasting disease”. Even today, fully healed after the invention of the multi-powered drugs, TB remains one of the most difficult diseases.

Emphysema, in which the lung is to heal another serious illness. In fact, modern medicine can not cure it not at all. While tuberculosis is manageable with highly effective antibiotics that kill bacteria that can eventually kill the germs before the patient can no antibiotic can repair the holes in the lungs, caused by the alveoli. And that’s the tragedy of emphysema.

Disease, emphysema and life expectancy

Emphysema is a chronic and progressive lung disease (lung) failure, and it is due to respiratory symptoms, shortness of breath, difficulty breathing and a feeling of being awkward marked during exercise. Although the symptoms in emphysema and chronic bronchitis are more or less similar, emphysema, breathing difficulties, a unique and singular appearance.

Studies show that emphysema is more common in men over the age of 65. And if someone is diagnosed with the disease in this age, many doctors give the person more than 3 years to live. Children and those in pregnancy may also be a victim. Of course, if life expectancy takes a beating here, but they can expect to live longer.

It can be said that the life expectancy goes down with age. But on the plus side at least emphysema is not contagious and there is no danger of the family members still involved.


The distinguishing symptoms are as much as 35% to 55% damage in the lung tissue, and most of this damage is irreparable. Based on the results of breathing tests (lung function test or PFT), there are four successive stages of emphysema, and they are …

Stage 1 – Mild

Level 2 – Moderate

Stage 3 – Severe

Stage 4 – very severe or terminal

Emphysema Life Expectancy and the role of spirometry

Spirometry is used to measure the volume / proportion of air exhaled by the patient in a second. This is medically known as FEV 1 or forced expiratory volume in 1 second. This is an important test because it gives the physician an estimate of the patient’s health status and how long he or she can live. For a normal healthy individual will move the spirometer reading between 80 and 100.

But for emphysema patients whose reading is below 35, the person belongs to stage 4, and this will mean that he or she is not expected to live long. However, with some information and effective action, the person will surely be able to survive for many years.

Diagnostic test results apart, some other factors also contribute to determine life expectancy emphysema. These include the patient’s body weight (less weight indicates a greater risk), how much he or she may, before experiencing breathing problems, the ability to cover resist viral or other infections, and others.

To improve life expectancy emphysema, doctors usually prescribe long-term oxygen therapy and this will also facilitate breathing problems. Small, portable oxygen tanks can provide 24-hour supply of oxygen, so that the life expectancy greatly. But the key is to act according to medical advice.

EMPHYSEMA LIFE EXPECTANCY

Emphysema happens when the air bag in your lungs are damaged slowly and gradually, so that you increasingly short of breath. Emphysema is one of many diseases collectively as chronic obstructive pulmonary disease (COPD) is known. Narrowing of the passages, the air bags is the normal course of the disease. The air is trapped in the alveoli, followed by the destruction of lung tissue because the tissue loss of elasticity.

Emphysema is a disease that is consistently ahead in principle and ultimately fatal infectious seen. Emphysema life expectancy may be longer or shorter depending on the person’s condition.

Causes of emphysema

There are many factors, emphysema, exposure to chemicals, air pollution, cigarette smoke and Alpha-1 Antitrypsin (AAT) deficiency causing. AAT is to function as a defense of the lung tissue to ensure air bags. People with AAT deficiency tend to have more vulnerable with emphysema. This deficiency is inherited.

Then again, a major cause of emphysema is smoking. Cigarette smoke contains chemicals that may damage the air sacs. The individual smoking is not the only one still at risk to this disease. People who are exposed to secondhand smoke can even them. If you feel difficulty in breathing, chronic cough, along with your weight loss, it is best to talk with your doctor immediately. Should you be identified as with emphysema, together with your doctor about the treatment of the condition to a better life expectancy with emphysema.

Average life expectancy emphysema

There have been many medical studies of emphysema life expectancy that the goal, the survival rate of patients with this chronic lung disease was estimated. They are no precise figures and data concerns as far as life expectancy emphysema found. The life expectancy might be inversely proportional to the levels of cruelty of the disease, serious illness or how long had to be influenced in terms of time and space. There are actually four stages of emphysema:

Stage 1 – Mild emphysema
Level 2 – Moderate emphysema
Stage 3 – severe emphysema
Stage 4 – very severe emphysema

If the stages of emphysema, it seems too wide, the next step to take to find out what stage it is clinically. These phases are designed by breathing tests called pulmonary function. Lung function tests are a group of tests in which, as effectively absorb the lungs and deflate, and how well they move gases such as oxygen from the atmosphere into the circuit to be measured.

The life expectancy after diagnosis of emphysema at the same time depends on a number of variables, not minimal, of which fully the degree to which the lung is damaged by the time of diagnosis. All play a role in your life expectancy. It is also consistent with all other factors such as gender, height, weight and age. But one thing is certain in life expectancy with emphysema is longer when given the proper medical care.

The treatment of emphysema

Emphysema due to smoking, chemicals and pollution caused an intensification of the disease that is incurable and treatment options for this disease is aimed primarily at reducing the severity of symptoms, to slow the risk of complications. But there is hope for 1-2% of victims of emphysema, those who have emphysema caused genetic deficiency of alpha-1-antitrypsin, a plasma proteinase inhibitor-enzyme.

As mentioned in the first part of this article a genetic deficiency of alpha-1-antitrypsin, may be a cause of emphysema. There is hope for this type of emphysema when medical science have found a way. The same enzyme alpha-1-antitrypsin is produced recently to address the shortage. The process of obtaining the enzyme contains recombinant DNA.

To describe the process of human gene for the protein of certain genes of animals like a sheep is connected. Produce the eggs of the female animal siblings would that produce the human protein in their milk. Extracted by milk-collection of the human protein, followed by the extraction of the APHA-1-antitrypsin from sheep milk.

Although it is difficult to cure this disease, emphysema, life expectancy may be longer. These treatments may be the regression of emphysema. The best tip would be to completely quit smoking and go to a dry and less polluted environment. If you continue to smoke even if you are with your treatments the disease could perhaps even worse quickly.

This is only to shorter life expectancy emphysema. People who are very serious conditions are generally not expected for more than 4 years to live. Emphysema to live longer by simply adhering to your doctor’s directions and the avoidance of things that can certainly be serious your condition.

Emphysema life expectancy and treatment

Emphysema is a serious lung disease, severe medical conditions that can lead to a shortened life expectancy, has. It is a condition that is usually achieved in old age. It is particularly common in older people but can make almost anyone. Over two million people in the United States are currently living with emphysema. Emphysema can shorten your life, but with proper treatment, the negative effects of the condition to minimize on your life.

Life expectancy for patients with emphysema

Emphysema is usually only about 40-50% of diagnosed lung tissue damage. This is definitely a problem because the patient is a point where treatment would be ineffective would be fairly achieved. Early diagnosis is important, with the ability to treat emphysema and maximize your life expectancy. The severity of the disease is measured in stages (stages 1 to 4) and your life expectancy may vary depending on what stage you are

A spirometer is necessary to determine the life expectancy of emphysema patients. For this practice, a device used to measure the FEV1 test. FEV1 is a term for forced expiratory volume over 1 second. This measurement is done exhaled by calculating the amount of air (in percent) that are out of the lungs in one second.

Test Results

The results of the FEV1 test will be displayed on the spirometer. A healthy person would have a high percentage for this test, as they are capable of breathing air from their lungs, most in a single second. The reading for a healthy person would be anywhere from 80% to 100%. An unhealthy person would have a relatively low percentage for this test because they are not able to exhale much air from their lungs. The reading of an unhealthy person, especially someone with emphysema, will be lower than 35%.

If the spirometer provides a reading of 35% or less of the patient’s life expectancy should be in about four years from diagnosis. By treating the condition, the symptoms may be subtle and could increase the life expectancy so many things that are a lot of time a patient left factor.

How long should you expect to live with emphysema?

Four years after diagnosis is only a rough estimate, but it is at the top end for most people. If you do not try this treatment for the condition then your life expectancy might have to fall as low as 2 years from diagnosis.

Your life expectancy will also vary depending on many other factors as well. For example, you can use your weight and general health play an important role in how long you are able to life with emphysema for the game. If you are underweight, then you are at highest risk of low life expectancy. Their current cardiovascular health may also be a good way to get your estimated life expectancy can be assessed.

How to treat emphysema

Because cigarette smoking is a major cause of emphysema, it would be obvious that you should avoid it are as much as possible if you have been diagnosed with this condition. You should also avoid secondhand smoke as much as possible. You may want to also initiate a contact with contaminated air or environments that further damage or irritation of the lungs to be avoided.

The treatment is not used to cure the condition, such as emphysema, an incurable condition. Emphysema treatment is only used to slow the disease and make your life expectancy as long as possible. There will be no major impact on your health, but we could minimize the severity of symptoms, a normal and healthy life so much easier and increase your life expectancy by a few years.

Medical treatment

The most common form of medical treatment for emphysema patients were taking medication that is made for emphysema patients. These drugs are not very beneficial for the treatment of your lung function capabilities, but they can help to minimize or eliminate various symptoms and make a healthy life much easier. You may also be capable of certain exercises, cardiovascular fitness is required if you follow the right treatment to perform.

You should definitely be taking medications to treat emphysema, as there are many health benefits that can provide the pills. Bronchodilators are most commonly used for the treatment of emphysema, but there are other drugs that might benefit you too. For example, antibiotics, vaccines, and glucocorticoids are all useful. However, these medications are usually used during certain phases. You should talk to your doctor about the appropriate medication for your condition.

Oxygen Therapy

This is another way to improve your health and living with emphysema much easier. It would increase your life expectancy as well. Oxygen therapy can be used in many ways. You could use it for a long time, just breathe while running a particular activity, or simply if you have difficulties to correct.

The long and frequent use of emphysema usually requires 15 hours or more of treatment each day. This can be stressful, but it can keep your organs functioning properly, you increase your overall health and improve the survival chances of the condition. The long-term use of oxygen therapy is most commonly used for emphysema patients in the fourth stage, as this is when it would be necessary. You could still have the therapy for a short stint at an earlier stage of emphysema, if you wish. However, there are many other preferred treatment methods for people in the early stages of emphysema.

Final Thoughts

Emphysema can have dramatic effects on your health and can lead you to an early death. If you are diagnosed with emphysema, then the need to seek treatment immediately. There are many options for treating the condition, if you are in the early stages of emphysema. If this is the case, then you should open as to treat the disease. People in the later stages of emphysema may be limited to certain serious treatments such as surgery or long-term oxygen therapy.

Finally, if you are diagnosed with emphysema, then you should talk to your doctor for a proper prognosis and suggestions on the best treatment for you.

Emphysema – Chronic Pulmonary

Pulmonary emphysema, also known as chronic obstructive pulmonary disease (COPD) affects 210 million people worldwide, of which 7 million in Brazil alone. The disease primarily affects the lungs, causing excessive dilation of their cells, which causes loss of respiratory capacity and insufficient oxygenation. This leads the patient to experience fatigue, shortness of breath and cough.


Like most carriers of the disease (90%) are smokers, quitting is the first step to alleviate the symptoms, which can and should be treated. Despite being a progressive disease, it is partly reversible and the symptoms can be relieved.

Treatment is the basis for prescription drugs, corticosteroids or bronchodilators, administered orally or by inhalation. Also through the oxygen, or oxygen therapy. Lung volume reduction surgery may be indicated in severe cases. Interventions in these areas most affected are removed from one or both lungs, in order to improve breathing and get relief from the symptoms of the disease.

Emphysema – Symptoms and Treatment

The heavy smokers and people who live or work in polluted atmospheres are at risk of contracting lung disease is progressive and incurable.

For smokers, the best way to prevent emphysema is to quit, but if not possible, make sure that your diet is rich in antioxidant nutrients.

These include vitamin C (found in fresh fruit), vitamin E (whole grains, Gemena wheat, nuts and seeds), and beta carotene (carrots, apricots, mangoes, spinach and broccoli).

Vitamins Antioxidants neutralize free radicals that can damage the cells and cause degenerative diseases.

The emphysema occurs when the tiny air sacs of the lungs (alveoli) become inflamed and the walls that separate them are broken, causing stiffness in the lungs and reducing the area through which oxygen is absorbed.

Now requires greater effort to expand the lungs, which implies a workload of the heart. In most cases, the extra effort eventually causes congestive heart failure.