Chronic Obstructive Pulmonary Disease (COPD) (cont.)
What are the symptoms of COPD?
Typically, after smoking 20 or more cigarettes a day for more than twenty
years, patients with COPD develop a chronic cough, shortness of breath (dyspnea)
and frequent respiratory infections.
In patients affected predominantly by emphysema,
shortness of breath may be the major symptom. Dyspnea usually is most noticeable during increased physical
activity, but as emphysema progresses, dyspnea occurs at rest.
In patients with chronic bronchitis as well as bronchiectasis, chronic cough
and sputum production are the major symptoms. The sputum is usually clear and
thick. Periodic chest infections can cause fever, dyspnea, coughing, production
of purulent (cloudy and discolored) sputum and wheezing. (Wheezing is a high
pitched noise produced in the lungs during exhalation when mucous, bronchospasm,
or loss of lung elasticity obstructs airways.) Infections occur more frequently
as bronchitis and bronchiectasis progress.
In advanced COPD, patients may develop cyanosis (bluish
discoloration of the lips and nail beds) due to a lack of oxygen in blood. They also may develop
morning headaches due to an inability to remove carbon dioxide from the blood.
Weight loss occurs in some patients, primarily (other possibility is reduced
intake of food) because of the additional energy that is required just to
breathe. In advanced COPD, small blood vessels in the lungs are destroyed, and
this blocks the flow of blood through the lungs. As a result, the heart must pump with
increased force and pressure to get blood to flow through the lungs. (The
elevated pressure in the blood vessels of the lungs is called pulmonary
hypertension.) If the heart cannot manage the additional work, right heart
failure also known as Cor pulmonale results and leads to swelling of the feet
and ankles. Patients with COPD may cough up blood (hemoptysis). Usually
hemoptysis is due to damage to the inner lining of the airways and the airways'
blood vessels; however, occasionally, hemoptysis may signal the development of
lung cancer.
Next: How is COPD diagnosed? »
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