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Clinical features in Emphysema.

Barrel-chested: increased AP diameter

Dyspneic with prolonged expiration

Sitting forward in a hunched-over position to squeeze air out of the lungs

Hyperventilation is prominent, so blood gas values are relatively normal- aka pink puffers

Others with mixed chronic bronchitis and a history of recurrent infections show less prominent dyspnea and respiratory drive, so they retain carbon dioxide, become hypoxic, and are often cyanotic- aka blue bloaters

Secondary pulmonary hypertension develops in both types due to hypoxia-induced pulmonary vascular spasm ( HPV)

Major causes of death:

Type II respiratory failure
Cor pulmonale.

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