COPD An Overview of Hyperinflated Lungs What to know about this common complication of lung disease By Deborah Leader, RN Deborah Leader RN, PHN, is a registered nurse and medical writer who focuses on COPD. Learn about our editorial process Deborah Leader, RN Medically reviewed by Medically reviewed by Sanja Jelic, MD on November 20, 2019 Sanja Jelic, MD, is board-certified in sleep medicine, critical care medicine, pulmonary disease, and internal medicine. Learn about our Medical Review Board Sanja Jelic, MD on November 20, 2019 Print Table of Contents View All Symptoms Causes Diagnosis Treatment Hyperinflation of the lungs (a.k.a. pulmonary hyperinflation) occurs when an increase in lung volume prevents efficient airflow in the body. Essentially, air gets trapped, either because of blocked airways or compromised air sacs, causing the lungs to retain air. This occurs with lung diseases such as chronic obstructive lung disease (COPD) and emphysema. Aside from breathing difficulties, this condition can also lead to heart disease. Diagnosis of lung hyperinflation involves imaging studies and may also include tests of respiratory and cardiac function. Medications can help relieve the effects, and surgical treatment (lung-volume reduction) may be used in severe cases. Symptoms It can be hard to distinguish the effects of hyperinflated lungs from the symptoms of the lung disease that caused it. If you have hyperinflated lungs, you may experience: Difficulty inhalingStruggling to breathShortness of breathFatigueLow energy Exercise intolerance is very common with lung hyperinflation. You may feel very short of breath or unusually exhausted during or after physical activity, be it a walk through the neighborhood or even cleaning your home. When lung hyperinflation is mild or just starting to develop, the symptoms may only be noticed during physical activity or exercise. Complications The biggest worry about hyperinflation of the lungs is that, over time, it affects heart function. One of the most common consequences is decreased blood volume in the left ventricle of the heart. When this happens, the heart pumps less oxygen-rich blood through the body, leading to exhaustion and fatigue. It also compresses the heart and may increase the risk of heart failure. Symptoms of Heart Failure Causes With every breath you take and exhale, your lungs inflate and deflate. But in cases of hyperinflation, the lungs enlarge more than they should with each inhalation. With every exhalation, the lungs do not deflate as much as they should. The expanded lungs, then, become larger than healthy lungs—but they do not have enough space for all that air. People with COPD can develop dynamic lung hyperinflation, static lung hyperinflation, or a combination of both. Diagnosis Hyperinflated lungs don't cause distinct symptoms. They also don't cause any change in a person's physical appearance. Your doctor may notice that your breathing is consistent with lung hyperinflation when listening to your chest examination with a stethoscope, but other changes caused by your underlying lung disease are likely to be more prominent. Because of the non-specificity of symptoms, hyperinflation of the lungs can sometimes be tricky to diagnose. Some studies have suggested that up to 19.8% of people with COPD are initially misdiagnosed by their primary care physician and require a specialist pulmonologist to make the correct diagnosis. In general, lung hyperinflation is detected with imaging tests, and the condition may be detected at an early or late stage. Complications of lung hyperinflation can be evaluated with tests such as an echocardiogram, which is a test of heart function. Imaging Tests Hyperinflated lungs can be identified on a chest X-ray, as well as a chest computed tomography (CT) scan. The radiologist will likely take images both during inspiration and expiration. Often, however, the condition is detected incidentally, meaning that lung hyperinflation was noticed on an imaging test done for another reason. Respiratory Tests Your medical team may measure your air volume with pulmonary function tests. You breathe in and out during this process, and a machine measures your air volume. Pulmonary Function Tests Cardiac Evaluation Because lung hyperinflation can cause heart failure, your doctor may also order some cardiac tests for you—especially if you have symptoms of heart disease. An echocardiogram is a non-invasive heart ultrasound test that can be used to visualize the movements of your heart. It evaluates heart function, measures blood volume as it flows through the heart chambers, and can detect signs of heart failure. Treatment There are several treatments used in managing lung hyperinflation. Medication can help with airway management. Lung volume reduction surgery is another approach and is an option in selected cases. Bronchodilators Medications used to widen the bronchi can help reduce lung hyperinflation. Long-acting bronchodilators work by expanding the bronchi for a sustained period of time. These medications can help improve the effects of lung hyperinflation. Bronchodilators reduce the impact of dynamic hyperventilation because the expansion of the bronchi provides space for air to exit the lungs. Lung-Volume Reduction Surgery Within your lungs, areas of severe lung disease are not effective when it comes to oxygen exchange. They take up space, compressing healthy lung tissue and the airway passages within them. The surgical removal of unhealthy lung tissue, called lung-volume reduction surgery, aims to alleviate this burden. It permits healthy areas of the lung to have space and can promote the growth of healthy tissue. In general, lung-volume reduction surgery is not considered a viable option if the lung damage is extensive. It is usually reserved for when the lung injury is limited or unilateral (involving one lung only). A Word From Verywell Lung hyperinflation is one of the most common effects of chronic lung disease. Enlarged lungs interfere with effective oxygen exchange. Over time, heart complications can develop. If you have a chronic lung disease, your medical team is likely to look for signs of lung hyperinflation on your diagnostic tests. Be sure to avoid exacerbating factors, such as smoking and exposure to pollutants. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Xu Y, Yamashiro T, Moriya H, et al. Hyperinflated lungs compress the heart during expiration in COPD patients: a new finding on dynamic-ventilation computed tomography. Int J Chron Obstruct Pulmon Dis. 2017;12:3123-31. doi:10.2147/COPD.S145599 Hui S, How CH, Tee A. Does this patient really have chronic obstructive pulmonary disease?. Singapore Med J. 2015;56(4):194-6. doi:10.11622/smedj.2015058 Pompeo E. Lung Volume Reduction Surgery for Emphysema Treatment: State-of-the-Art and Perspectives. ISRN Pulmonol. 2014;2014:418092. doi:10.1155/2014/418092 Additional Reading Milenkovic B, Janjic SD, Popevic S. Review of lung sealant technologies for lung volume reduction in pulmonary disease. Med Devices (Auckl). 2018 Jun;11:225-31. doi:10.2147/MDER.S127136 Rossi A, Aisanov Z, Avdeev S, et al. Mechanisms, assessment and therapeutic implications of lung hyperinflation in COPD. Respir Med. 2015 Jul;109(7):785-802. doi:10.1016/j.rmed.2015.03.010 Struß N, Bauersachs J, Welte T, Hohlfeld JM. Left heart function in COPD : Impact of lung deflation. Herz. 2019 Sep;44(6):477-82. doi:10.1007/s00059-019-4816-5