The symptoms caused by Alpha-1-related emphysema are the same as those of any emphysema patient. Generally, shortness of breath following activity is the first thing people notice. This worsens as more and more air sacks are damaged, and eventually the bronchial tubes leading to the air sacks collapse, trapping air in the lungs and making it harder and harder to get a good breath. The lungs also become less elastic, making it difficult to exhale too, and wheezing is common. Most people experience a progressive decline in exercise capacity as a result. Eventually, people are short of breath even while at rest.