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Emphysema Stages: Here's What You Need to Know

Medically reviewed by Regina Victoria Boyles, MD · Pediatrics

Written by Jan Alwyn Batara · Updated Nov 13, 2022

Emphysema Stages: Here's What You Need to Know

Emphysema is a condition that affects a person’s respiratory system. It is also a progressive disease, which means that if not treated, the conditions worsens and passes through different stages of emphysema. Doctors usually refer to emphysema, and COPD as a whole, using different stages. This helps them better identify how severe a person’s condition is, and what forms of treatment they can provide.

What are the GOLD emphysema stages?

The Global Initiative for Chronic Obstructive Lung Disease created a system that breaks down emphysema into different stages. These are commonly known as the GOLD stages. They measure a person’s condition using FEV1, which stands for forced expiratory volume in one second.

FEV1 simply refers to the maximum amount of air a person can force out from their lungs in one second. The higher the FEV1 percentage a person has, the healthier their lungs are. And this is what’s used to divide COPD into four different stages.

Here is the breakdown of each stage:

Stage 1: Mild

In the first stage of emphysema, also known as “mild,” a person usually has an FEV1 of about 80 percent or higher. This means that their ability to breathe is not the best, but it’s closer to normal compared to the other stages.

For the most part, people at this stage usually don’t regularly experience any symptoms of COPD. However, it is possible that during strenuous activities, they might find themselves out of breath. People at this stage also usually don’t get diagnosed, since the symptoms are very mild and occasional.

Stage 2: Moderate

The second stage, “moderate,” means that a person’s FEV1 is between 50 to 80 percent.

A person might be short of breath even if they’re just engaging in moderate physical activity. They also might find themselves coughing in the morning to relieve a buildup of mucus.

People at this stage of emphysema might also find it difficult doing certain daily tasks such as cleaning the house or doing simple chores because they quickly run out of breath.

Some people also experience tiredness or fatigue and difficulty breathing at this stage. This is usually the stage where people check in with their doctors to see if they have any respiratory problems. It’s also very possible for a person’s symptoms to gradually worsen, especially if they don’t seek any treatment. This is why it is important to get in touch with your doctor if you are having a hard time breathing.

emphysema stages

Stage 3: Severe

In the third stage of emphysema, a person’s FEV1 is around 30 to 50 percent. What this means is that their ability to breathe has been greatly affected, and they can experience some of the following symptoms:

  • Easily tires
  • Often suffers from shortness of breath
  • Tightness in the chest
  • Frequently has colds
  • Finds it difficult to breathe while exercising
  • It’s also possible for a person at this stage to have a faster heartbeat or tachycardia, difficulty talking, and bluish or greyish lips or fingernails. These symptoms are a cause for concern, and it would be best to seek medical attention as soon as possible. These symptoms mean that your body is experiencing a recurrent, severe loss of oxygen and needs medical assistance.

    Stage 4: Very severe

    The last stage of emphysema is very severe COPD. At this stage, a person’s FEV1 is less than 30 percent. This is also known as end-stage COPD, because people who have COPD usually progress to this stage later on in life.

    For people at this stage, breathing would take a lot of effort. The previous symptoms they experience, such as frequent coughing, mucus buildup, and running out of breath, are more pronounced during this stage.

    A person at this stage is also more prone to infections, and might find it hard to eat and engage in any physical activity. This can further cause their condition to deteriorate. In some cases surgery or a lung transplant is the only way to treat this condition.

    Key takeaways

    Knowing the different emphysema stages can help people better understand just how this condition affects their overall health. When it comes to emphysema and COPD, it is important to seek medical attention as early as possible to ensure that your condition does not get any worse.

    Learn more about Respiratory Health here


    Hello Health Group does not provide medical advice, diagnosis or treatment.

    Medically reviewed by

    Regina Victoria Boyles, MD


    Written by Jan Alwyn Batara · Updated Nov 13, 2022

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