In summary, the cigarette destroys the lung for the triad: increase of elastase? inativao of inhibitors of the elastase-blockade of neoformacao of the elasstina. As it is seen, the cigarette develops enfisema, either for half mechanics, through the chronic bronchitis, or for enzymatic ways. In the two cases, almost always associate, the accumulation of the alveolar macrophages and the neutrofilos in the bronchioles respiratory terminals and produces in these small farms bigger release of elastase, reason why enfisema of the smoker is predominantly of the type to centrolobular. SYMPTOMS KNOBEL (2003) relate that: ‘ ‘ The chronic bronchitis is characterized by presence of productive chronic cough for three months, per two years consecutive, since that other causes of chronic cough have been excludas’ ‘. The diagnosis of enfisema pulmonary cannot be based only on the symptoms. A description is necessary focando in the amount and occupational duration of these symptoms and habits and tobacco. The doctor will examine the chest, observing the breath standards, and will monitor the effort that the person makes to breathe.
The examination also will include the comment of the degree of total inflation of the pulmes, to listen to the chest with a estetoscpio to hear the air flow, and to listen to sounds that determine the tax and rhythm of any signal of violent effort of the heart that can follow the advanced periods of training of enfisema. Additionally, tests of the pulmonary function can determine some characteristics and capacities of the pulmes. These tests include espirometria, measurement of the gas in the arterial blood, oximetria of pulse, and ray-x. The main symptom of enfisema it is the lack of breath or the sensation not to be inalando enough air. The person can visit the doctor initially because she felt air lack during an activity, but to the measure that the illness progresses this symptom can be present all the time..