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[Fatal outcome of emphysema without increased bronchial resistance and 6 cases of chronic dyspneic hypoxemic bronchial disease with normal spirometry].

The cases of seven patients with dyspnea, hypoxemia and normal ventilatory tests are presented. Closing volume was measured in 6 and was increased. Two were heavy smokers, 2 were obese, and 2 were exposed to inhalation of industrial irritants. The last patient had severe dyspnea and pronounced hypoxemia which eventually resulted in pulmonary hypertension and right ventricular failure. Lung scan was normal. Plethysmography showed normal bronchial resistance. Autopsy revealed chronic bronchitis, bronchiolectasis and emphysema. This case was interpreted as an example of fatal outcome of small airway disease.