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Emphysema occurs when the air sacs (alveoli) in the lungs are irreversibly destroyed. This is most often caused by cigarette smoking. The alveoli lose elasticity and become weak. As air sacs are destroyed, the lungs are less able to transfer oxygen to the bloodstream, causing shortness of breath. Support of the airways is also lost, obstructing airflow.

Emphysema comes on gradually, with the patient usually noticing shortness of breath as he or she engages in exercise. Symptoms increase over time if not addressed. Emphysema often co-exists with Chronic Bronchitis.