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Atrial fibrillation and atrial flutter - Emphysema Factor
In the SOP for Chronic bronchitis and emphysema the RMA defines emphysema as "a bilateral and diffuse respiratory tract disorder which is characterised by distension of airspaces distal to the terminal bronchiole with destruction of alveolar septa, and without obvious fibrosis. This definition excludes isolated emphysematous bleb and surgical, traumatic, unilateral, focal or localised emphysema, and Swyer-James syndrome (also known as MacLeod's syndrome or hyperlucent lung syndrome)."
Establishing a history of emphysema
Specific spirometric or other evidence is not required. Spirometry results will generally be available (either provided or obtained for assessment purposes). If that spirometry does not show the usual obstructive pattern associated with emphysema, ie FEV1 £ 85% of predicted and FEV1/FVC) ratio £ 75%, then the diagnosis should not be confirmed without other evidence in support and further investigation should be undertaken.
A history of emphysema should be recorded in doctor’s notes and/or hospital records. However, if these records cannot be obtained, a reliable history of appropriate symptoms or medical treatment at a particular time generally will be accepted, provided this is not negated by other evidence. Seek medical advice if it is unclear whether the claimed symptoms and treatment at that time can be attributed to emphysema rather than to some other condition.
Last reviewed for CCPS 16 July 2003.
Preliminary questions 
3819 the veteran has had emphysema at some time.
34723 the veteran suffered from emphysema at the time of the clinical onset of the condition under consideration.
34724 the veteran has established the causal connection between the emphysema and VEA service for the clinical onset of the condition under consideration.
34725 the veteran has established the causal connection between the emphysema and operational service for the clinical onset of the condition under consideration.
34726 the veteran has established the causal connection between the emphysema and eligible service for the clinical onset of the condition under consideration.
Clinical onset and operational service 
34727 the emphysema is causally related to operational service.
Clinical onset and eligible service 
34728 the emphysema is causally related to eligible service.