An Overview of Hyperinflated Lungs

What to know about this common complication of lung disease

Doctor Auscultating a Patient
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Hyperinflation (over inflation) of the lungs occurs when an increase in lung volume prevents efficient airflow in the body. This occurs with lung diseases such as chronic obstructive lung disease (COPD) and emphysema.

You may experience breathing difficulties due to hyperinflation of the lungs. This condition also leads 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 of lung hyperinflation. Surgical treatment, described as lung volume reduction surgery, may help reduce the severity of the condition.

Symptoms

In general, hyperinflated lungs do not cause recognizable symptoms. That is because the condition is so closely related to advanced lung diseases. 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 inhaling
  • Struggling to breath
  • Shortness of breath
  • Fatigue
  • Low energy

Exercise intolerance is very common with lung hyperinflation. You may feel very short of breath or unusually exhausted during or after physical activity.

Often, when lung hyperinflation is mild or just beginning to develop, the symptoms are only noticeable with exertion or physical exercise.

Complications

Over time, hyperinflation of the lungs affects heart function. Oxygen flows from the lungs to the left side of the heart.

One of the most prominent effects of long term lung hyperinflation is a decrease in blood volume and oxygen in the left side of the heart. The heart pumps less oxygen-rich blood throughout the body—which manifests with exhaustion, fatigue, and low energy.

Further complications, such as heart failure, can develop. This is why diagnosis and treatment of lung hyperinflation are so important.

Causes

With each inhaled breath, the lungs expand, and with each exhaled breath, the lungs partially deflate. With lung hyperinflation, the lungs enlarge more than they should with each inhalation and do not deflate as much as they should with each exhalation.

When you have lung hyperinflation—the expanded lungs are larger than healthy lungs—but they do not have enough space for air.

Lung disease makes it difficult for oxygen to travel efficiently between the alveoli (air pockets) and the nearby capillaries (tiny blood vessels) that lead to the heart. Lung hyperinflation makes the situation even worse.

There are two ways that lung disease causes hyperinflation to develop—and they are described as dynamic hyperinflation and static hyperinflation.

Dynamic Hyperinflation

The more common type of hyperinflation is called dynamic hyperinflation. It is related to active lung movements.

Lung disease is characterized by inflammation, mucus plugging, and scarring—all of which narrows the airways. When the airways are narrow, it takes more time to fully exhale. As you begin to inhale before fully exhaling, the lungs expand beyond their normal range—which is dynamic hyperinflation.

Static Hyperinflation

The airways of healthy lungs have elastic tissue that helps them to expand and deflate efficiently. Static hyperinflation occurs when lung disease reduces the inherent elasticity of the airways.

With each expiration, the alveoli do not deflate as they should. The decreased elasticity of the bronchi may prevent air from exiting the lungs efficiently, adding to alveolar expansion.

You 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.

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 computerized tomography (CT) scan. Often, the condition is detected incidentally—meaning that the imaging test was obtained for another reason—and the lung hyperinflation was noticed.

You will likely have imaging tests to include some images during inspiration, and some during expiration.

Respiratory Tests

Your medical team may measure your air volume with pulmonary function tests. You would breathe in and out during this process, and a machine would measure your air volume.

With lung hyperinflation, your total lung capacity (the amount of air you can breathe in and out) may be lower than standard, while the residual volume (the amount of air remaining in your lungs) could be higher than average.

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. Surgery is riskier than medication, but in some cases, it is the most effective option.

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 air exchange. But they take up space, compressing your nearby healthy lung tissue.

Surgical removal of unhealthy lung tissue reduces lung volume. This permits healthy areas of the lung to have space, and it can also promote the growth of healthy lung tissue.

In general, lung volume reduction surgery is not considered a suitable approach if the lung disease is spread throughout the lungs. It is considered more likely to be effective when the area (or areas) of lung disease is limited.

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.

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