"A 24-year-old presenting with emphysema is unusual," says Dr. Albert Rizzo, speaker for the American Lung Association nationwide assembly.
One explanation for a 20- or 30-something who is experiencing the early stages of emphysema is a specific genetic defect, Rizzo says. People who have this inherited condition lack a protein that protects lung tissue from breaking down. This genetic problem can be found through a blood test and treated through medications that replace the missing protein.
If Winehouse doesn't have this genetic abnormality, though, her alleged crack cocaine use could be the culprit.
Cocaine causes blood vessels to constrict, which leads to increased blood pressure in the lungs, says Dr. John Spangler, director of tobacco intervention programs at Wake Forest University School of Medicine. If these blood vessels constrict for a long period of time, such as during heavy crack-cocaine use, blood and oxygen can't through the lungs. This results in scarring and permanent damage.
Doctors typically detect emphysema or crack lung in a chest x-ray, MRI scan or lung function test after a patient complains of chronic shortness of breath and coughing. But these symptoms may come years after the problem begins.
"The lungs have an incredible amount of reserve power," says Edelman. "They were designed for chasing lions in the forests. A fair amount of lung function can be lost before people notice it, unless they are competitive athletes."
Whether or not Winehouse was suffering from a loss of lung function at the time of her admission remains a mystery. Edelman says such symptoms are unlikely in the early stages of the disease.
"I doubt that she has symptoms if she is still blessed with singing," Edelman says.
Emphysema isn't just a condition for the heavy smokers, however.
"Emphysema is really an aging process of our lung that we will all go through if we live long enough," Rizzo says.
The air sacs in our lungs naturally break down as we age, but cigarette smoking and other drugs can speed up this process, causing irreversible damage.
"The lung doesn't regroup," Edelman says. "It doesn't repair itself. Once the damage is done, it's done."
Thus, the first step to preventing and treating both crack lung and emphysema seems easy: "Don't smoke anything. If you're smoking anything, stop it," Horovitz says.
But for many, that part is far from simple. Spangler says he deals with people who are addicted to smoking every day, and sees them struggle to break the habit. Certain people may need more intense smoking cessation programs, including medication and counseling.
"But it's essential to quit," Spangler says.
Along with quitting, treatments that slow the progression of emphysema include inhaled steroids to treat lung inflammation and other inhaled medications to open up the airways.
But because Winehouse is so young, permanent damage done to her lungs may eventually require a more radical treatment to keep her healthy as she gets older.
"The thing you start thinking about is a lung transplant," Rizzo says.