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A variety of pulmonary function tests may be ordered. In the early stages of emphysema, the only result may be dysfunction of the small airways. Patients with emphysema may show an increase in the total amount of air that is in the lungs (total lung capacity), but a decrease in the amount of air that can be breathed out after taking a deep breath (vital capacity). With severe emphysema, vital capacity is substantially below normal. Spirometry, a procedure that measures air flow and lung volume, helps in the diagnosis of emphysema.
A chest x ray is often ordered to aid in the diagnosis of emphysema, though patients in the early stages of the disease may have normal findings. Abnormal findings on the chest x ray include over-inflation of the lungs and an abnormally increased chest diameter. The diaphragm may appear depressed or flattened. In addition, patients with advanced emphysema may show a smaller or vertical heart. The physician may observe blisters in the lungs and bulging of the accessory muscles of the respiratory system. Late in the disease, an EKG will show signs of right ventricular failure in the heart and increased hemoglobin due to lower levels of oxygen in the patient's blood.
— Deanna Swartout-Corbeil, RN
