Alayne Ronnenberg, ScD
The symptoms of COPD are mild at first. They become more severe and debilitating as the disease progresses.
Cough that produces a lot of mucus is a common symptom of COPD. Coughing may be worse during a cold or respiratory infection.
A whistling or rustling sound may be heard when exhaling, which is prolonged. Wheezing often worsens with a cold or respiratory infection.
This symptom develops as COPD becomes progressively worse. At first, shortness of breath may only occur with physical exertion. As the disease becomes more advanced, it may occur after very modest activity. When the illness becomes very severe, shortness of breath occurs even at rest.
Even very mild activities produce significant shortness of breath. Repeated bouts of coughing with sputum production may become disabling. Nighttime coughing may interfere with sleep. You may feel a choking sensation when lying flat.
Difficulty breathing may cause sufferers to breathe through pursed lips, or to lean forward when sitting or standing in order to breathe more comfortably.
COPD makes the heart work harder, especially the right side of the heart. This side pumps blood to the lungs. The walls of the heart become thickened from the extra work needed to pump blood into the resistant lungs. The normal rhythm of the heart may be disturbed. Lack of oxygen in your blood can produce a bluish tinge to your skin, nails, and lips. This is called cyanosis.
The extra strain on the right side of the heart may cause a slowdown of blood circulation. This, in turn, can cause engorgement of the large veins and liver, and eventually fluid leakage into the abdomen, legs, and ankles (edema). This right-sided heart failure is called
Because COPD destroys the normal lung structure, you cannot exhale completely. Air is trapped in the lungs, which become hyperinflated. This causes the chest to expand, leading to a permanent condition referred to as “barrel chest.”
The accumulation of mucus and fluid in the lungs provides an ideal environment for bacteria and viruses to grow. These lung infections may become serious, further compromising breathing ability.
About COPD. American Lung Association website. Available at:
http://www.lung.org/lung-disease/copd/about-copd. Accessed October 1, 2012.
COPD. EBSCO DynaMed website. Available at:
https://dynamed.ebscohost.com/about/about-us. Updated September 25, 2012. Accessed October 1, 2012.
What is COPD? National Heart, Lung, and Blood Institute (NHLBI) website. Available at:
http://www.nhlbi.nih.gov/health/health-topics/topics/copd. Accessed October 1, 2012.
What you can do about a lung disease called COPD. Global Initiative for Chronic Obstructive Lung Disease website. Available at:
http://www.goldcopd.org/uploads/users/files/GOLD_Patient_RevJan10.pdf. Accessed October 1, 2012.
Last reviewed October 2012 by Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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