What causes the shortness of breath in individuals with emphysema?

Shortness of breath in individuals with emphysema is primarily caused by damage to the air sacs in the lungs, known as alveoli. In emphysema, the walls of these air sacs are destroyed, leading to a reduced surface area for gas exchange. This damage hampers the ability of oxygen to enter the bloodstream and carbon dioxide to be expelled, resulting in the feeling of breathlessness.

The destruction of alveoli leads to less efficient gas exchange during both inhalation and exhalation. As a result, patients experience not only difficulty breathing but also an increased effort required to breathe, which can further contribute to fatigue and anxiety around breathing.

Other factors, such as overproduction of mucus or infections, could lead to respiratory issues, but the primary mechanism in emphysema is the structural damage to the alveoli. This fundamental pathology underlies the characteristic symptoms of the condition, including persistent shortness of breath.